经膝下途径导管直接溶栓治疗混合型下肢深静脉血栓形成.

Objective: To evaluate the safety and efficacy of Catheter-Directed Thrombolysis (CDT) in the treatment of mixed deep venous thrombosis(DVT) via the Below the Knee(BTK) access. Methods: The clinical data of patients with acute mixed DVT treated with CDT by the BTK access in the department of interventional radiology, Xuzhou Cancer Hospital from January 2013 to October 2017 were retrospectively analyzed. The patients included 26 males and 12 females with an average age of 54± 11 years old. Results: The technical success rate was 100%. Interventional procedures were performed through small saphenous vein puncture (28 cases), small saphenous vein incision(4 cases), posterior tibial vein incision (4 cases), and posterior tibial vein puncture (2 cases). All CDTs were implanted with a temporarily recyclable filter preoperatively and removed within 2 weeks after surgery. Thirty-six patients achieved successful thrombolysis(Grades II and III). Two patients who did not gain thrombolytic success had a time of more than 10 days from symptom onset to CDT. 13 patients (10 cases on the left and 3 cases on the right) underwent balloon dilatation and stent implantation. During perioperative period, there were 4 cases of incision bleeding, 5 cases of numbness at the incision site, and no major complications such as new pulmonary embolism and major hemorrhage. The average follow-up time was 2 years (1 month to 4years) and 28 patients exceeded 1.5 years. Two patients had repeated patellae DVT due to not taking warfarin. The patency rate and PTS rate during follow-up were 81.6%(31/38) and 31.6%(12/38), respectively. Conclusion: The use of CDT via BTK approach in DVT is feasible and safe and may be considered an alternative to traditional CDT approach. [ABSTRACT FROM AUTHOR]