Lee Sangjoon, Cho Youngjong, Lee Hyoung Nam, Park Sung-Joon, Chung Hwan Hoon, Park Hyerim
Vascular Center, The Eutteum Orthopedic Surgery Hospital, Paju-si, Republic of Korea.
Department of Radiology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung-si, Republic of Korea.
J Belg Soc Radiol. 2023 Aug 16;107(1):60. doi: 10.5334/jbsr.3213. eCollection 2023.
To evaluate the efficacy and safety of single-session percutaneous mechanical thrombectomy (PMT) for deep vein thrombosis (DVT), to compare clinical outcomes and recurrences between acute and subacute DVT, and to identify factors predicting recurrence.
From January 2018 to March 2021, 100 consecutive patients (age: 64.64 ± 17.28 years; male, 42%) with symptomatic DVT who underwent single-session PMT were enrolled for this study. These patients were divided into an acute DVT group (< 14 days, = 75) and a subacute DVT group (15-28 days, = 25).
A large-bore aspiration thrombectomy was used in 80 (80%) cases, Angiojet (Boston Scientific, Marlborough, MA, USA) device in one (1%) case, and a combination of both techniques in 19 (19%) cases. The anatomic success rate was 97% and the clinical success rate was 95%. There were no major complications. Clinical outcomes were not different between the two groups. The recurrence-free survival rate in the acute DVT group was significantly ( = 0.015) better than that in the subacute DVT group. The anatomic success (HR, 52.3; 95% CI, 3.82-715.21; = 0.003) and symptom duration (HR, 17.58; 95% CI, 1.89-163.34; = 0.012) were predictive factors associated with recurrence.
Single-session PMT is safe and effective for immediate symptom relief in acute and subacute DVT patients. However, recurrence occurred more frequently in patients with subacute DVT than in those with acute DVT. Anatomic success of the procedure and duration of symptoms were independent predictors of DVT recurrence.
评估单次经皮机械血栓切除术（PMT）治疗深静脉血栓形成（DVT）的有效性和安全性，比较急性和亚急性DVT的临床结局和复发情况，并确定预测复发的因素。
2018年1月至2021年3月，100例连续接受单次PMT治疗的有症状DVT患者（年龄：64.64±17.28岁；男性，42%）纳入本研究。这些患者分为急性DVT组（<14天，n = 75）和亚急性DVT组（15 - 28天，n = 25）。
80例（80%）采用大口径抽吸血栓切除术，1例（1%）采用Angiojet（美国波士顿科学公司，马尔伯勒，马萨诸塞州）装置，19例（19%）采用两种技术联合使用。解剖成功率为97%，临床成功率为95%。无重大并发症。两组临床结局无差异。急性DVT组的无复发生存率显著优于亚急性DVT组（P = 0.015）。解剖成功（HR，52.3；95%CI，3.82 - 715.21；P = 0.003）和症状持续时间（HR，17.58；95%CI，1.89 - 163.34；P = 0.012）是与复发相关的预测因素。
单次PMT对急性和亚急性DVT患者立即缓解症状是安全有效的。然而，亚急性DVT患者的复发比急性DVT患者更频繁。手术的解剖成功和症状持续时间是DVT复发的独立预测因素。
