Preliminary Study Of AngioJet On Vascular Endothelial Cell Injury In Patients With Acute DVT

Objective:To evaluate whether the Angiojet device damages the vascular endothelium by monitoring the vascular endothelial injury markers thrombomodulin(TM)and von Willebrand factor(v WF),and to provide new ideas for the optimization of Angiojet in the treatment of deep vein thrombosis(DVT)and the treatment related to endothelial cell injury.Methods:Forty-four patients with acute lower extremity deep venous thrombosis who were admitted to the Department of Vascular Surgery,Shanxi Dayi Hospital from April 2018 to November 2018 were selected.According to the treatment methods,the patients were divided into the thrombus aspiration group(experimental group)and the conservative treatment group(control group).Among them,21 patients(10 males and 11 females)were in the thrombus aspiration group,and 23 patients(16 males and 7 females)were in the conservative treatment group.The fasting elbow venous blood was extracted preoperatively and 12 h postoperatively in the thrombus aspiration group,and the blood was drawn simultaneously in the conservative treatment group and the thrombus aspiration group.The changes of TM and v WF indexes in plasma were measured by enzyme-linked immunosorbent assay.Results:1.There was no significant difference in age,gender,BMI,affected limbs and thrombosis between the thrombus aspiration group and the conservative treatment group(P>0.05).2.There was a statistically significant difference in TM concentration between the thrombus aspiration group and the conservative treatment group(P<0.001).The TM level after treatment was higher than that before treatment.There was no significant difference in the concentration of TM in the thrombus aspiration group((4.73 ±1.11)ng/ml)compared with the conservative treatment group((4.96±1.17)ng/ml)(P=0.491).The concentration of TM in the thrombus aspiration group((9.15 ± 1.02)ng/ml)was higher than that in the conservative treatment group((7.74 ± 0.61)ng/ml),and the difference was statistically significant(P<0.001).3.The difference of v WF concentration between the thrombus aspiration group and the conservative treatment group was statistically significant(P<0.001).The v WF level after treatment was higher than that before treatment.There was no significant difference in v WF concentration((1098.12±253.20)ng/ml)between the thrombus aspiration group and the conservative treatment group((1037.33 ± 221.48)ng/ml)(P=0.400).The concentration of v WF in the thrombus aspiration group after treatment((2174.11 ±306.77)ng/ml)was higher than that in the conservative treatment group((1865.40 ±226.68)ng/ml),the difference was statistically significant(P<0.001).Conclusion:1.In patients with acute DVT,the plasma TM and v WF levels both increased after Angiojet thrombus aspiration,indicating that Angiojet thrombus aspiration may has a damaging effect on the endothelium of veins?2.Endothelial injury plays an important role in the process of thrombosis.Therefore,it should be considered to add drugs to improve vascular endothelial injury into the whole treatment plan to achieve better therapeutic effects...