Efficacy Of Mechanical Thrombectomy Combined With Balloon Dilation And Stenting Treatment Of Lower Extremity Deep Vein Thrombosis Combined With Iliac Vein Compression Syndrome

Objective:This study discusses the safety and efficacy of mechanical thrombectomy combined with simple balloon dilation and stenting in the first stage treatment of deep venous thrombosis of the lower extremity with iliac vein compression syndrome.Methods:Based on clinical data from patients with acute deep venous thrombosis of the lower limb combined with iliac vein compression syndrome treated by mechanical thrombus removal combined with balloon dilation and stent implantation in the Department of Vascular Surgery of Gan Su Province Hospital were collected from January2018 to June 2022.Patients were divided into two groups according to whether iliac vein stenting was performed;1.46 patients in the PMT+PTA+Stent group received Angio Jet mechanical thrombectomy combined with balloon dilation and iliac vein stenting;2.52 patients in the PMT+PTA group received Angio Jet PMT combined with balloon dilation.The short-term results were evaluated by the rate of relief of swelling in the affected limbs and the change of venous clinical severity score in both groups;the incidence of postoperative deep venous PTS and the patency rate of iliac veins were used as indicators for the evaluation of the mid-term efficacy;safety was evaluated by incidence of pulmonary embolism,hemorrhage,venous rupture,and stent displacement.Results:In this research,98 patients experiencing lower limb deep vein thrombosis combined with iliac vein compression syndrome were selected.The two groups of patients had similar baseline data and no significant differences in the rate of intraoperative thrombus clearance or postoperative relief of limb swelling.Additionally,there was no difference in pre/post-operative VCSS scores between these patient groups during the6-month follow-up period.However,over a longer timeframe(12 months),there was a notable variance in first-stage target vessel patency rates between those who underwent PMT+PTA treatment versus those who received PMT+PTA+Stent therapy: specifically,the latter group showed higher patency rates at 86.96%(40/46)while the former only achieved a patency rate of 69.23%(36/52).This difference reached statistical significance(P<0.05).Furthermore,individuals treated solely via PMT + PTA displayed an incidence rate of PTS reaching up to 30.77%(16/52);by comparison,the occurrence of PTS among people receiving both PMT + PTA + Stent therapies decreased significantly to 10.87%(5/46)(P<0.05).Finally,regarding Villalta scores,PMT+PTA group’s score averaged out at(6.02±1.45),whereas that for individuals undergoing complementary treatment using stents stood on average at just(4.85±1.40)(P<0.05).Conclusions:Endovenous treatment of patients with lower limb DVT combined with iliac vein compression syndrome has a high technical success rate,significantly improves patients’ clinical symptoms,has a high mid-term target vessel patency rate,and has significant near-to mid-term efficacy;compared with PMT combined with balloon dilation,PMT combined with balloon dilation and stent implantation in one phase for lower extremity DVT combined with iliac vein compression syndrome is a more effective and safe treatment.PMT combined with balloon dilation and stent implantation was a more effective and safe treatment for lower extremity DVT combined with iliac vein compression syndrome than PMT combined with balloon dilation.