Objective To investigate the feasibility and efficacy of transcatheter directed thrombolysis （TDT） approach in treatment for deep venous thrombosis （DVT） of lower limbs and as compared with trans-dorsal pedis vein thrombolysis （TPVT） approach.
Methods The clinical data of 437 patients with acute DVT （184 males and 253 females） at the age of （43±12） years （range 19-76 years） from July 2008 to January 2012 in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. Patients in the group TDT received TDT were 293 cases， 32 inferior vena cava filters were implanted. Patients in the group TPVT received TPVT were 65 cases， 4 inferior vena cava filters were implanted.
Results The resolution time of thrombus in the group TDT was shorter than that in the group TPVT （6 d versus 9 d， P＜0.05）. The circumference difference of leg or upper leg before and after treatment in the TDT group was significantly greater than that in the TPVT group （P＜0.05）. The rate of venous patency was （65.2±15.4）% and preservation rate of valvular function was （78.2±12.6）% in the group TDT， and which was （63.8±16.3）% and （91.1±10.7）% in the group TPVT， respectively. The differences of venous patency rate was not statistically significant（P＞0.05） between two groups， but the prevervation rate of valvular function was significant difference （P＜0.05） .Hematomas in 3 cases and gross hematuria in 4 cases were observed， and displacement of inferior vena cava filter occurred in 1 patient in the group TDT. The gums bleed or gross hematuria in 5 cases were observed in the group TPVT.
Conclusions Both TDT and TPVT can effectively relieve symptoms. TDT can shorten the course of disease， but it
increases functional damage of the deep vein valvular.
Citation：
ZHANG Wenguang,LI Zhen,HAN Xinwei,DING Pengxu,WANG Zhiwei,ZHOU Pengli,XU Peng,JI Feng,LI Zhitong,WANG Zhonggao. Comparative Analysis Approach for Transcatheter Directed Thrombolysis and Trans-Dorasalis Pedis Vein Thrombolysis in Treatment for Deep Venous Thrombosis of Lower Limbs. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(11): 1171-1174. doi:
Copy
Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
| 1. |
Stein PD， Matta F， Musani MH， et al. Silent pulmonary embolism in patients with deep venous thrombosis：a systematic review[J]. Am J Med， 2010， 123(5)：426-431.
|
| 2. |
Jenkins JS. Endovascular therapies to treat iliofemoral deep venousthrombosis[J]. Prog Cardiovasc Dis， 2011， 54(1)：70-76.
|
| 3. |
Comerota AJ. The current role of operative venous thrombectomy in deep vein thrombosis[J]. Semin Vasc Surg， 2012， 25(1)：2-12.
|
| 4. |
Guyatt GH， Akl EA， Crowther M， et al. American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary：Antithrombotic therapy and prevention of thrombosis， 9th ed：American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest， 2012， 141(2 Suppl)：7S-47S.
|
| 5. |
中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第2版)[J]. 中华外科杂志， 2012， 50(7)：611-614.
|
| 6. |
Jacobs LG， Billett HH. Office management of deep venous thrombosis in the elderly[J]. Am J Med， 2009， 122(10)：904-906.
|
| 7. |
中华医学会放射学分会介入学组. 下肢深静脉血栓形成介入治疗规范的专家共识[J]. 中华放射学杂志， 2011， 45(3)：293-296.
|
| 8. |
Angel LF， Tapson V， Galgon RE， et al. Systematic review of the use of retrievable inferior vena cava filters[J]. J Vasc Interv Radiol， 2011， 22(11)：1522-1530.
|
| 9. |
Imberti D， Ageno W， Manfredini R， et al. Interventional treatment of venous thromboembolism：a review[J]. Thromb Res， 2012， 129(4)：418-425.
|
| 10. |
汪忠镐. 15例股青肿的外科治疗[J]. 北京医学， 1987， 9(2)：77-80.
|
| 11. |
Lou WS， Gu JP， He X， et al. Endovascular treatment for iliac vein compression syndrome：a comparison between the presence and absence of secondary thrombosis[J]. Korean J Radiol， 2009， 10(2)：135-143.
|
| 12. |
韩冰， 张磊， 张宏光， 等. 下腔静脉滤器植入、溶栓、手术治疗下肢深静脉血栓形成[J]. 中国普通外科杂志， 2004， 13(1)：6-8.
|
| 13. |
汪忠镐. 汪忠镐血管外科学[M]. 杭州：浙江科学技术出版社， 2010：1110-1158.
|
- 1. Stein PD， Matta F， Musani MH， et al. Silent pulmonary embolism in patients with deep venous thrombosis：a systematic review[J]. Am J Med， 2010， 123(5)：426-431.
- 2. Jenkins JS. Endovascular therapies to treat iliofemoral deep venousthrombosis[J]. Prog Cardiovasc Dis， 2011， 54(1)：70-76.
- 3. Comerota AJ. The current role of operative venous thrombectomy in deep vein thrombosis[J]. Semin Vasc Surg， 2012， 25(1)：2-12.
- 4. Guyatt GH， Akl EA， Crowther M， et al. American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary：Antithrombotic therapy and prevention of thrombosis， 9th ed：American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest， 2012， 141(2 Suppl)：7S-47S.
- 5. 中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第2版)[J]. 中华外科杂志， 2012， 50(7)：611-614.
- 6. Jacobs LG， Billett HH. Office management of deep venous thrombosis in the elderly[J]. Am J Med， 2009， 122(10)：904-906.
- 7. 中华医学会放射学分会介入学组. 下肢深静脉血栓形成介入治疗规范的专家共识[J]. 中华放射学杂志， 2011， 45(3)：293-296.
- 8. Angel LF， Tapson V， Galgon RE， et al. Systematic review of the use of retrievable inferior vena cava filters[J]. J Vasc Interv Radiol， 2011， 22(11)：1522-1530.
- 9. Imberti D， Ageno W， Manfredini R， et al. Interventional treatment of venous thromboembolism：a review[J]. Thromb Res， 2012， 129(4)：418-425.
- 10. 汪忠镐. 15例股青肿的外科治疗[J]. 北京医学， 1987， 9(2)：77-80.
- 11. Lou WS， Gu JP， He X， et al. Endovascular treatment for iliac vein compression syndrome：a comparison between the presence and absence of secondary thrombosis[J]. Korean J Radiol， 2009， 10(2)：135-143.
- 12. 韩冰， 张磊， 张宏光， 等. 下腔静脉滤器植入、溶栓、手术治疗下肢深静脉血栓形成[J]. 中国普通外科杂志， 2004， 13(1)：6-8.
- 13. 汪忠镐. 汪忠镐血管外科学[M]. 杭州：浙江科学技术出版社， 2010：1110-1158.
