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Objective To: explore the efficacy and safety of interventional therapy for acute central pulmonary thromboembolism (PTE). Methods: Data of 72 patients with acute central PTE were retrospective analyzed. Interventional therapy of PTE were performed in all patients, then "one-stop" interventional therapy of deep venous thrombi of lower extremity were also performed in 65 patients. Complications during and after therapies were observed. Pulmonary artery pressure and D-dimer level were measured after interventional therapy and compared with those before treatment. The therapeutic effect was evaluated during follow-up. Results: No serious complication occurred. Heart rate arrhythmia and blood pressure rise during operation happened in 7 patients, blood leakage around thrombolytic catheter and subcutaneous ecchymosis at puncture point after operation were observed in 9 and 5 patients, respectively, all relieved after symptomatic treatment. Pulmonary artery pressure decreased significantly after interventional thrombectomy combined with catheter thrombolysis ([30.11±14.50]mmHg vs [40.22±17.58]mmHg, t=3.77, P<0.01), and D-dimer level also decreased significantly ([623.32±267.41]ng/ml vs [3 634.38±1 567.61]ng/ml, t=12.56, P<0.01) compared with those before treatment. The mean follow-up time was (15.92±5.22) months, and the total effective rate of interventional therapy of PTE was 97.22% (70/72). Complete thrombosis clearance or clearance rate of lower extremity higher than or equal to 95% (grade III) were observed in 61 patients (61/65, 93.85%) combined with PTE and deep venous thrombosis of lower extremities, while the rest 4 patients (4/65, 6.15%) had thrombosis clearance rate higher than or equal to 50% but lower than 95% (grade Ⅱ). Conclusion: Interventional therapy is safe and effective in treatment of acute central PTE, especially for patients with lower extremity deep venous thrombosis.
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Objective To observe the curative effect of catheter thrombolysis in the treatment of subacute lower limb arterial occlusion.Methods Eighty-five patients with subacute lower limb arterial occlusion (98 limbs) and treated with catheter thrombolysis were enrolled and the removal of thrombus and patency of vessels were evaluated by angiography.Then,balloon dilatation or stent implantation was performed according to the angiographic findings after thrombolysis. Results After catheter thrombolysis, the degree and length of occlusion were significantly improved (P < 0.01). To judge the curative effect: significantly effective in 5 limbs (5.1%), effective in 85 limbs (86.7%), ineffective in 8 limbs(8.2%),total effective rate was 91.8%.Catheter thrombolysis combined with balloon dilatation and stent implantation were performed according the vascular occlusion status and all the occluded segments were open, the postoperative angiography showed no distal vascular occlusion. No bleeding occurred. Conclusions Catheter thrombolysis is effective and safe in the treatment of lower extremity arterial occlusion in subacute stage.Endovascular treatment combined with endovascular treatment can achieve good results.
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Objective:To compare the clinical efficacy of catheter thrombolysis and systemic thrombolysis for deep venous thrombosis of the lower extremities.Methods:102 cases of unilateral deep venous thrombosis of the lower extremities were selected from February 2013 to July 2015 in our hospital.With randomly method divided into the observation group and the control group,each had 51 cases,patients in the control group were treated with systemic thrombolytic therapy,patients in the observation group underwent catheter thrombolysis,also all patients were followed up.The clinical effect was compared between the two groups.Results:In the observation group,thigh swelling rate,leg swelling rate,the patency rate of vein thrombolysis rate were significantly higher than control group;the thrombolysis time of observation group was (5.2 ± 1.7) d,significantly lower than that of control group (6.8 ± 2.1) d,the difference was statistically significant (t=4.229,P=0.000);observation group's cases of vascular patency was significantly higher than the control group,while the residual amount of thrombus was significantly lower than the control group.The differences were statistically significant (P＜0.05).Conclusion:Catheter thrombolysis treatment of lower extremity deep venous thrombosis effect significantly,can shorten the patient's blood flow recovery time,and the deep vein patency rate is far superior to the systemic thrombolysis treatment.
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Objective To discuss and analyze the issue in the catheter directed thrombolysis(CDT) treatment of acute lower extremity deep venous thrombosis.Methods The clinical data of 182 cases of acute lower extremity deep venous thrombosis from January 2011 to January 2013 which were treated by CDT were retrospectively analyzed,and the issues in these treatment were discussed and analyzed.Results The effect were classified into three degrees.Thrombosis clearance exceed 95 percent belonged to the first degree,among 50 percent and 95 percent belonged to the second degree,and below 50 percent belonged to the third degree.In this study,the respective number of each degree were 93/68/21.Sixty-one cases combined iliac venous compression syndrome were treated by stent.Twenty-two cases were treated with inferior vena cava filter.All the patients were followed up 10 months,148 cases of them maintained patency.Conclusions The effect of CDT treatment to acute lower extremity deep venous thrombosis is remarkable,meanwhile the patency is improved and the deep vein thrombosis were decreased through this method.But the issues of access,filter and iliac venous compression syndrome should also be considered.
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Objective To evaluate the efficacy of intraluminal catheter-directed thrombolysis in treatment of lower limb acute deep venous thrombosis(DVT).Methods Thirty-six consecutive patients with lower limb acute DVT underwent intraluminal cathter-directed thrombolysis with urokinase continuous infusion immediately.The circumferences of the normal and affected limbs were measured before and after lysis,the venous patency scores and the rates of patency improvement were observed by venograms,together with follow up record after 6 months.Results After lysis,the circumferencial differences in thigh and calf showed significant difference(P
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PURPOSE: Catheter directed thrombolytic dissolution (CDT) of deep vein thrombus (DVT) is in widespread use, yet the complications especially pulmonary embolism (PE), associated with the procedure remains ill defined. To assess the incidence of PE we reviewed the clinical course of acute DVT patients treated by CDT. METHOD: From January 2000 to September 2003, 25 patients were treated by CDT. To define the new development of PE, patients had a technetium 99m lung scan before and just after CDT-, and clinical symptoms were recorded. All patients underwent ascending venogram and CT scan initially to define DVT extension. CDT with urokinase was done by a the same intervention radiologist. RESULT: Proximal thrombus extension level was the femoral vein in 8 patients, iliac vein in 12-, and inferior vena cava (IVC) in 5. Complete thrombolysis was achieved in 16 patients, partial lysis in 2 and no lysis in 7. PE was detected in 7 patients with initial lung scan whose thrombus proximal level was IVC 2, iliac vein 4, femoral vein 1 in each, and no changes in lung scan after CDT. In 17 patients with normal findings at intial lung scan, there were also no changes after CDT. One patient with normal lung scan showed high probable scan defects in lung scan after CDT. Because he also complained of sudden onset dyspnea with cough, we diagnosed him as newly developed, PE-related CDT. CONCLUSION: Only one (4%) case of PE was developed in our study. No prediction factor of PE such as CDT results, or thrombus proximal extent could be defined. These findings suggest that routine usage of temporary IVC filter is unnecessary during CDT.
Subject(s)
Humans , Catheters , Cough , Dyspnea , Femoral Vein , Iliac Vein , Incidence , Lung , Pulmonary Embolism , Technetium , Thrombosis , Tomography, X-Ray Computed , Urokinase-Type Plasminogen Activator , Veins , Vena Cava, Inferior , Venous ThrombosisABSTRACT
Objective To evaluate the efficacy of catheter-directed thrombolysis in the treatment of lower limb acute deep venous thrombosis(DVT). Methods One hundred and four patients with lower limb acute DVT underwent cathter-directed thrombolysis with continuous infusion of urokinase(154.27 ? 76.31 ? 104 IU). Fourteen pationts were implanted with stents for the residual stenoses. The circumferences between normal and affected limbs were measured before and after the thrombolysis. The venous patency score, the rate of patency improvement were eveluated by venography and the patients were followed up for six months. Results After thrombolysis, the venography revealed that venous patency improved in 92 patients(mean 52.42% ? 16.37%, P