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find Keyword "Thrombolysis of endovascular" 1 results
  • Minimally Invasive Therapy in Acute Deep Venous Thrombosis of Lower Extremities

    Objective To discuss the clinical effect and value of minimally invasive therapy on lower extremity deep venous thrombosis (DVT). Methods The clinical data of 911 patients with acute lower extremity DVT from April 1998 to December 2011 were analyzed retrospectively. There were 489 males,422 females;the age ranged from 23-86 years old with (58.72±11.95) years old. Five hundred and sixty-eight patients occurred on the left leg,343 patients on the right leg. There were 487 cases of central type,166 cases of peripheral type,258 cases of mixed type. All the patients were implanted inferior vena cava filter under local anesthesia,then inserted an 8-14 F catheter via the femoral vein of the affected limbs to suck mechanically thrombus. Five hundred and twenty-seven cases of iliofemoral vein thrombus were inserted into sheathing canal with the help of technique of guide wire griped. The guide wire could be plugged into femoral vein,even more far,with the help of sheathing canal. Following the guide wire,a diameter-10 mm balloon catheter was used to pull the thrombus to iliac vein,with the watching of DSA,so it could be sucked from iliac vein. Before sucking thrombus,a diameter-12 mm balloon was put into the confluence of inferior vena cava and iliac vein,in case of thrombus fall off with blood flow to block inferior vena cava. Results Among 911 patients,423 cases were only treated by sucking thrombus,275 cases sucking thrombus plus endovascular thrombolysis,91 cases sucking thrombus plus endovascular thrombolysis plus percutaneous transluminal angioplasty (PTA),122 cases sucking thrombus plus endovascular thrombolysis plus PTA plus stenting,the average hospital stay was 7.5 d. ① Discharge success rate:907 (99.56%) cases were successful by interventional therapy,4 (0.44%) cases were failed. Nine hundred and eleven patients were performed mechanical thrombus suction,which was 556 cases of gradeⅢ,142 cases of gradeⅡ,213 cases of gradeⅠ. Among 213 cases of gradeⅠ,there were 91 cases only underwent PTA treatment for economic reasons or advanced stage malignant tumors,122 cases underwent PTA plus stenting. The circumferences of affected limb and the differences of circumference of healthy and affected limbs knees above and below 15 cm at discharge were significantly smaller than those at admission (P<0.01). Twenty-seven cases underwent anticoagulation and thrombolytic therapy after operation,which occurred mild subcutaneous bleeding,gum bleeding,epistaxis,hematuria,and the symptoms were disappearance after adjusting drugs. All the patients did not appear to complications such as bleeding,vessel dissection. ② Follow-up effective rate:After 6 to 12 months follow-up,there were 714 (78.38%) cases of excellent,136 (14.92%) cases of good,57 (6.26%) cases of middle,4 (0.44%) cases of poor. After 13 to 24 months follow-up,there were 691 (76.18%) cases of excellent,151 (16.65%) cases of good,65 (7.17%) cases of middle;65 cases occurred restenosis that the PTA and stent placement was underwent again, blood flow of 58 cases completely restored,blood flow of 7 cases partly recovered,and the contrast agent didn’t retent. After 25 to 36 months follow-up,there were 681 (75.08%) cases of excellent,128 (14.11%) cases of good,98 (10.81%) cases of middle;98 cases of limb swelling were not satisfied,and the patients still had a sense of pain after walking,but the symptoms obviously improved as compared with preoperative symptoms,the patients were advised to wear stretch socks with no further interventional therapy. Conclusions Minimally invasive therapy on lower extremity DVT can eliminate thrombus from venous cavity more early,restore the unobstructed flow instantly,preserve the function of venous valve in a greater degree. It has an advantage of minimally invasive,less complications,and notable clinic effect of short-term and medium-term follow-up.

    Release date:2016-09-08 10:36 Export PDF Favorites Scan
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