Department of Vascular Surgery, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China.
Department of Vascular Surgery, Beijing Chao Yang Hospital, Affiliate of Capital Medical University, Beijing, China.
Ann Vasc Surg. 2021 Jul;74:306-314. doi: 10.1016/j.avsg.2020.12.024. Epub 2021 Jan 26.
Pharmacomechanical thrombolysis (PMT) and catheter-directed thrombolysis (CDT) are frequently employed for treating deep venous thrombosis (DVT). However, there have been relatively few studies comparing PMT outcomes to those associated with CDT. The present study was thus designed to compare short- and mid-term PMT and CDT patient outcomes following the treatment of DVT of the lower extremities.
This study was a retrospective analysis of 98 patients treated at the 3rd Affiliated Hospital of Shenzhen University (Shenzhen, China) and Beijing Chao Yang Hospital (Beijing, China). All patients had undergone treatment for symptomatic DVT of the lower legs via either CDT or PMT. Clinical records and outcome data between the patients in these 2 treatment groups were compared.
Of the 98 patients analyzed in this retrospective study, 50 had been treated via CDT while 48 had undergone PMT. These PMT and CDT operations were associated with mean treatment durations of 0.97 ± 0.20 hr and 32.48 ± 7.46 hr, respectively (P < 0.0001). Complete lysis was achieved in 78 patients (42 and 36 in the PMT and CDT groups, respectively P = 0.057), while effective lysis was achieved in 96 patients (48 and 48 in the PMT and CDT groups, respectively P = 0.162), with lysis being ineffective in the 2 remaining patients. PMT was associated with a significantly decreased length of hospital stay, usage of UK dose, and treatment duration relative to CDT(P < 0.0001). No major complications or MACE incidence were noted in either group, although 18 patients in the PMT group suffered from bradyarrhythmia (P = 0.007). Clinical efficacy was achieved in 96 patients (48 in each treatment group) at time of discharge (P = 0.162). A Kaplan-Meier analysis revealed that 2-year primary patency rates did not differ significantly between these 2 groups (P = 0.442).
PMT is an effective treatment modality in patients with symptomatic DVT. Relative to CDT it is associated with high treatment success rates, reduced treatment duration, and reduced hospitalization duration, although it is also associated with higher rates of systemic complications.
机械溶栓（PMT）和导管溶栓（CDT）常用于治疗深静脉血栓形成（DVT）。然而，比较 PMT 与 CDT 结果的研究相对较少。本研究旨在比较下肢 DVT 治疗后 PMT 和 CDT 的短期和中期患者结局。
这是一项对在深圳大学第三附属医院（深圳，中国）和北京朝阳医院（北京，中国）接受治疗的 98 例患者进行的回顾性分析。所有患者均通过 CDT 或 PMT 治疗症状性小腿 DVT。比较这 2 种治疗组患者的临床记录和结局数据。
在这项回顾性研究中，98 例患者中有 50 例接受 CDT 治疗，48 例接受 PMT 治疗。PMT 和 CDT 治疗的平均治疗时间分别为 0.97±0.20 小时和 32.48±7.46 小时（P＜0.0001）。78 例患者完全溶解（PMT 和 CDT 组分别为 42 例和 36 例，P=0.057），96 例患者有效溶解（PMT 和 CDT 组分别为 48 例和 48 例，P=0.162），2 例患者溶解无效。与 CDT 相比，PMT 显著降低了住院时间、UK 剂量使用和治疗持续时间（P＜0.0001）。两组均未发生重大并发症或 MACE 发生率，但 PMT 组有 18 例患者出现缓慢性心律失常（P=0.007）。出院时，96 例患者（每组 48 例）达到临床疗效（P=0.162）。Kaplan-Meier 分析显示，两组 2 年原发性通畅率无显著差异（P=0.442）。
PMT 是治疗症状性 DVT 的有效治疗方法。与 CDT 相比，它具有较高的治疗成功率、较短的治疗持续时间和较短的住院时间，但也与更高的全身并发症发生率相关。
