Efficacy comparison of interventional thrombectomy versus thrombolysis in the treatment of acute mixed-type lower extremity deep venous thrombosis
Zhang, X.-q.; Yu, W.-n.; Wang, Y.-p.; Pan, J.-j.; Zhu, L.; Zhu, W.; Zhang, Q.
Zhonghua Yi Xue Za Zhi 93(31): 2454-2458
2013
ISSN/ISBN: 0376-2491 PMID: 24300263 Document Number: 664349
To compare the clinical efficacy of interventional thrombectomy versus thrombolytic treatment for acute mixed-type lower extremity deep venous thrombosis (LEDVT). The clinical data of 458 patients with acute mixed type LEDVT were analyzed retrospectively.Group A: 327 patients underwent mechanical aspiration thrombectomy; Group B: 131 patients received systematic thrombolysis and anticoagulation with urokinase and heparin. Complete thrombus removal (Grade I): Group A was was better than group B (65.44% vs 37.4%) (P = 0.000). The circumference differences of healthy and affected limbs of knee-joints' below and above 15 cm at discharge were (1.34 ± 0.57) and (0.93 ± 0.32) cm in group A were better than (1.72 ± 0.69) and (1.29 ± 0.43) cm in group B (both P = 0.000). Among them, 411 patients had a median follow-up period of 35 (16-70) and the follow-up rate was 89.83%. At 36 months postoperation, the circumference difference of affected limbs of knee-joints' below 15 cm for group A (0.53 ± 0.22) cm was better than that for group B (1.42 ± 0.65) cm (P = 0.000) . And the sequelae occurrence rates of edema, pigmentation and ulceration of group A (29.64%, 14.01%,0%) were lower than those of group B (55.77%, 83.65%, 9.62%) (both P = 0.000). Color Doppler flow imaging revealed that the vein patency rate of group A was 90.23% and normal valve function rate 71.34%. And both were better than group B (37.50%, 15.38%) (P = 0.000; P = 0.000). The total effective rate of group A (100%) was better than that of group B (71.15%) (P = 0.000). Excellency rate: group A (88.93%) was higher than group B (29.81%) (P = 0.000). Interventional thrombectomy is better than simple thrombolysis in the treatment of acute mixed-type lower extremity deep venous thrombosis. And the former offers better protection of normal valve function.