Chen G P, Gu J P, He X, Lou W S, Wang Y, Chen L, Su H B, Shi W Y, Wang T
Department of Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Zhonghua Yi Xue Za Zhi. 2017 Feb 7;97(5):353-358. doi: 10.3760/cma.j.issn.0376-2491.2017.05.007.
To compare the clinical efficacy differences between anterograde and retrograde catheterization interventional treatment for acute low extremity deep venous thrombosis(DVT). The clinical data of 217 patients with acute low extremity DVT between January 2009 and December 2014 were analyzed retrospectively. Group A: 67 patients underwent treated with anterograde catheterization interventional treatment. Group B: 150 patients underwent treated with retrograde catheterization interventional treatment. The degree of thrombolysis in different anatomical sites, clinical effective rate, femoral-popliteal vein valve reflux and the incidence of post-thrombotic syndrome(PTS) were all analyzed. There were no statistical differences in the degree of thrombolysis (≥50%) of common iliac vein, external iliac vein and common femoral vein between group A (83.6%, 88.1%, 91.0%)and B (80.7%, 82.0%, 88.0%)(all >0.05). The degree of thrombolysis (≥50%) of superficial femoral vein in group A(94.0%) was significantly higher than that of group B (75.3%)(=0.001). There was no significantly difference in the clinical effective rate at discharged between group A (80.6%) and B(76.7%)( =0.519). During follow-up of 44±15 months, There was no statistical difference in the patency rate of the iliofemoral vein, the valvular regurgitation of patent femoropopliteal vein and the incidence of PTS between group A(70.2%, 25.4%, 35.8%) and B (60.0%, 31.5%, 40.0%)(all >0.05). The incidence of PTS in patients with iliofemoral vein patency(13.1%) was significantly lower than that in patients with iliofemoral vein occlusion (82.5%)(<0.01). The anterograde or retrograde catheterization interventional treatment can be used for treating acute low extremity DVT and get comparable clinical effect.The retrograde catheterization does not increase venous valve damage. The recovery of iliofemoral vein lumen patency is the main task in the treatment of DVT and can significantly reduce the incidence of PTS.
比较顺行与逆行导管介入治疗急性下肢深静脉血栓形成（DVT）的临床疗效差异。回顾性分析2009年1月至2014年12月期间217例急性下肢DVT患者的临床资料。A组：67例患者接受顺行导管介入治疗。B组：150例患者接受逆行导管介入治疗。分析不同解剖部位的溶栓程度、临床有效率、股腘静脉瓣膜反流及血栓形成后综合征（PTS）的发生率。A组（83.6%、88.1%、91.0%）与B组（80.7%、82.0%、88.0%）在髂总静脉、髂外静脉及股总静脉的溶栓程度（≥50%）方面无统计学差异（均>0.05）。A组股浅静脉的溶栓程度（≥50%）为94.0%，显著高于B组的75.3%（P =0.001）。A组出院时临床有效率为80.6%，B组为76.7%，差异无统计学意义（P =0.519）。在44±15个月的随访期间，A组（70.2%、25.4%、35.8%）与B组（60.0%、31.5%、40.0%）在髂股静脉通畅率、通畅的股腘静脉瓣膜反流及PTS发生率方面均无统计学差异（均>0.05）。髂股静脉通畅患者的PTS发生率（13.1%）显著低于髂股静脉闭塞患者（82.5%）（P<0.01）。顺行或逆行导管介入治疗均可用于治疗急性下肢DVT，临床效果相当。逆行导管介入治疗不会增加静脉瓣膜损伤。恢复髂股静脉管腔通畅是DVT治疗的主要任务，可显著降低PTS的发生率。
