Inferior Vena Cava Filter Combined With AngioJet Drug Mechanical Coupling To Remove Deep Venous Thrombosis Of Lower Extremities To Prevent Pulmonary Embolism

Objective:A retrospective analysis of patients with deep venous thrombosis in our hospital from February 2017 to August 2018 was conducted to investigate the effects and complications of indwelling inferior vena cava filter combined with AngioJet drug mechanically coupled thrombectomy for pre-pulmonary embolization.Methods:All patients were routinely placed in the Inferior Vena Cava Filter(IVCF)before AngioJet drug mechanical coupling to remove deep venous thrombosis of lower extremities?A total of 37 clinical patient data were collected?The filter was Celect of Cook Company.The filter is placed through the healthy femoral vein or the right internal jugular vein.Deep venography of affected limbs was used to assess the extent and extent of the lesion?If the standard course of thrombolytic anticoagulant therapy is used,the angiography confirms that there are no fresh thrombus and free floating thrombus in the inferior vena cava,iliac vein,femoral vein,or iliac vein,or the intravascular thrombus disappears after treatment or the family and their own request to take out the filter?If there is a high risk of PE,such as pulmonary embolism and thrombophilia,or there are still more fresh thrombus or free floating thrombus in the inferior vena cava,iliac vein,femoral vein and iliac vein,permanently indwelling filter,long-term oral anticoagulant drugs and regular monitoring of coagulation function were requested?During the follow-up period,the inferior vena cava and iliac veins were regularly reviewed.If the condition changes,the inferior vena cava and angiography should be reviewed immediately.AngioJet mechanical thrombectomy,indwelling thrombolysis catheter assisted urokinase thrombolysis,selective iliac vein and inferior vena cava balloon dilatation,stent implantation for Deep Vein Thrombosis(DVT).Follow-up through the outpatient department,telephone,etc.,review the lower extremity color Doppler ultrasound and clotting function.Outpatient and telephone follow-up,color Doppler ultrasound and coagulation function of lower extremities were examined to assess the relief of related symptoms and to observe short-term and long-term complications.Results:37 patients were successfully completed with AngioJet drug mechanically coupled thrombus removal and IVCF implantation?Two patients had a stenosis of the axillary vein.PTA balloon dilatation catheter and stent placement were performed.IVCF was successfully placed between the right renal vein and the bifurcation of the iliac vein.All IVCF were placed in the predetermined part of the inferior vena cava,and no reset due to improper position.The filter placement success rate reached 100%.Among them,25 filters were successfully removed,12 patients were permanently placed in the body,and 2 cases successfully blocked the embolus.There were 22 males and 15 females.The deep vein thrombosis was located in the right lower limb in 9 cases,the left lower limb in 20 cases,the lower extremities in 5 cases,and the inferior vena cava thrombus in 3 cases.The postoperative symptoms of 37 patients were relieved to varying degrees.The difference in the circumference of the thighs from the suffering limb decreased from 5.3±0.8 cm to 1.9±0.6cm(p<0.05),The mean dose of urokinase(40.3±3.7)U,thrombus aspiration time(462.5±9.3)seconds.Thirty patients had complete DVT(>90%),5 were mostly cleared(50%to 90%),and 2 were partially cleared(<50%).Three patients had transient gross hematuria after surgery,and were relieved on the day after adequate rehydration of hydration and alkalization of urine.No serious complications such as pulmonary embolism and massive hemorrhage occurred.Conclusion:Indwelling retrievable inferior vena cava filter combined with AngioJet drugs and mechanical coupling thrombectomy is an efficient,safe and effective method for the treatment of acute DVT with few complications.