Department of Clinical Radiology, Kuopio University Hospital, Digital Imaging Centre, Kuopio, Finland.
Eur J Radiol. 2012 Jun;81(6):1197-202. doi: 10.1016/j.ejrad.2011.03.068. Epub 2011 Apr 16.
To prospectively evaluate the primary and long-term venographic and clinical results of catheter-directed thrombolysis in the treatment of proximal deep vein thrombosis (DVT) of lower extremity.
Fifty-six patients with mean age of 48 (range 15-81) years with acute DVT (symptom duration of less than 2 weeks), extending to high femoral (16 patients) or iliac vein (40 patients) were treated with selective catheter-directed thrombolysis. The mean total dose of 3.8 (range 1.0-8.1) million units of urokinase was administered during a mean of 39 (range 6-72) hours. Endovascular stenting was performed in 9 of the iliac DVT patients.
Complete procedural venographic success was achieved in 79% of patients. Major complications were noted in 7% of patients and the total rate of complications was 13%. Mean venographic follow-up was 3.5 years (range 3 months to 9.6 years); well preserved femoral vein valves and fully recanalized deep crural veins were observed in 83% and 57% of patients. Normal clinical findings in the affected limb were noted during the latest follow-up visit in 67% of patients. Clinical post-thrombotic syndrome occurred in 9% of patients.
Catheter-directed thrombolysis achieves good primary success with acceptable complication rate and effectively reduces prevalence of post-thrombotic syndrome.
前瞻性评估导管定向溶栓治疗下肢近端深静脉血栓形成（DVT）的初始和长期静脉造影和临床结果。
56 例平均年龄为 48 岁（范围 15-81 岁）的急性 DVT（症状持续时间小于 2 周）患者，血栓延伸至股总静脉（16 例）或髂静脉（40 例），采用选择性导管定向溶栓治疗。平均给予 3.8（范围 1.0-8.1）百万单位尿激酶的总剂量，平均给药时间为 39（范围 6-72）小时。9 例髂静脉 DVT 患者进行了血管内支架置入术。
79%的患者获得了完全的静脉造影成功。7%的患者出现了主要并发症，并发症总发生率为 13%。平均静脉造影随访 3.5 年（范围 3 个月至 9.6 年）；83%和 57%的患者观察到股静脉瓣膜保持良好和深小腿静脉完全再通。67%的患者在最近的随访中观察到受累肢体的临床症状正常。9%的患者发生了血栓后综合征。
导管定向溶栓治疗具有良好的初始成功率，并发症发生率可接受，能有效降低血栓后综合征的发生率。
