Large-lumen catheter aspiration combined with catheter-directed thrombolysis for Budd-Chiari syndrome with inferior vena cava thromboses / 中国介入影像与治疗学

ABSTRACT

Objective: To observe the safety and efficacy of large-lumen catheter aspiration combined with catheter-directed thrombolyses (CDT) and angioplasty for Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) thromboses. Methods: A total of 74 patients with BCS combined with IVC fresh or mixed mainly fresh thromboses were selected, 32 cases were enrolled into thrombi aspiration group and 42 cases into simple thrombolytic group. Patients in thrombi aspiration group underwent CDT and endovascular angioplasty combined with large-lumen catheter aspiration, while those in simple thrombolytic group underwent only CDT and endovascular angioplasty. The thrombolytic effect, thrombolytic time, the amount of thrombolytic medicine and complications were compared between the two groups. Results: The technical success rate of the two groups were both 100%. The average thrombolytic time and the average dosage of urokinase in the thrombi aspiration group were all less than those in simple thrombolytic group (both P<0.05). In thrombi aspiration group, grade III, grade Ⅱ and grade thrombectomy were observed in 12, 19 and 1 cases, while in simple thrombolytic group were found in 17, 20 and 5 cases, respectively, and there was no significant difference between the two groups (P=0.33). Complications occurred in 2 patients (2/32, 6.25%) in thrombi aspiration group and 3 patients (3/42, 7.14%) in simple thrombolytic group, and no significant difference was found between 2 groups (P=1.00). Conclusion: Large-lumen catheter aspiration combined with catheter-directed thrombolysis can shorten the thrombolytic time, reduce the amount of thrombolytic drugs, therefore being safety for treating BCS with IVC thromboses.