Department of Vascular and Interventional Radiology, 385685Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of Radiology, 579164The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221124903. doi: 10.1177/10760296221124903.
: This study investigates the safety and efficacy of endovascular treatments on pregnancy-related iliofemoral deep vein thrombosis (DVT). : We retrospectively reviewed data of 46 patients who had symptomatic pregnancy-related iliofemoral DVT and underwent endovascular treatment. The patients treated with catheter-directed thrombolysis (CDT) were classified as the CDT group. In contrast, those treated with CDT combined with pharmacomechanical thrombectomy (PMT) or angioplasty/stenting were classified as the pharmacomechanical catheter-directed thrombolysis (PCDT) group. : Based on the immediate post-operative clot burden reduction rate analysis of 46 patients: 22 cases were completely dissolved (lysis grades III), 12 were partially dissolved (lysis grades II), and 12 failed (lysis grades I). There was a statistically significant difference in the rate of clot burden reduction between the CDT group (n = 19) and the PCDT group (n = 27) ( = 0.001). There was no statistically significant difference in the number of bleeding events between the two groups ( = 0.989). At 24 months, cumulative venous patency in the CDT group was 50.0%, compared to 78.2% in the PCDT group. Furthermore, there was a statistically significant difference in Villalta score = 0.001) and venous severity scoring (VCSS score) = 0.005) between the two groups. : CDT treatment combined with PMT or angioplasty/stenting is comparatively safe and effective for pregnant-related DVT patients. PCDT outperforms CDT in terms of immediate efficacy and reduces the incidence of post-thrombotic syndrome with better midterm outcomes.
本研究探讨了血管内治疗妊娠相关髂股深静脉血栓形成（DVT）的安全性和有效性。我们回顾性分析了 46 例有症状妊娠相关髂股 DVT 并接受血管内治疗的患者数据。接受导管直接溶栓（CDT）治疗的患者被分为 CDT 组。相比之下，接受 CDT 联合药物机械血栓切除术（PMT）或血管成形术/支架置入术治疗的患者被分为药物机械导管直接溶栓（PCDT）组。根据 46 例患者术后即刻血栓负荷减少率分析：22 例完全溶解（溶解分级 III），12 例部分溶解（溶解分级 II），12 例失败（溶解分级 I）。CDT 组（n=19）与 PCDT 组（n=27）的血栓负荷减少率差异有统计学意义（=0.001）。两组出血事件的数量差异无统计学意义（=0.989）。24 个月时，CDT 组的静脉通畅率为 50.0%，而 PCDT 组为 78.2%。此外，两组间 Villalta 评分（=0.001）和静脉严重程度评分（VCSS 评分）（=0.005）差异有统计学意义。CDT 治疗联合 PMT 或血管成形术/支架置入术治疗妊娠相关 DVT 患者相对安全有效。PCDT 在即刻疗效方面优于 CDT，并降低了血栓后综合征的发生率，中期结果更好。
