A Retrospective Comparison of Catheter-Directed Thrombolysis versus Pharmacomechanical Thrombolysis for Treatment of Acute Lower Extremity Deep Venous Thrombosis.

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.

Efficacy of propranolol and pingyangmycin, respectively, combined with pulsed dye laser on children with hemangioma.

Clinical efficacy of propranolol and pingyangmycin, respectively, combined with pulsed dye laser in the treatment of children with hemangioma was analyzed, to provide a new therapeutic idea for their clinical treatment. A total of 120 children with hemangioma were selected into the study. Children treated with propranolol combined with pulsed dye laser were in group A, those treated with pingyangmycin combined with pulsed dye laser were in group B, and 60 healthy children were selected as control group (group C). Blood samples of children were taken before and after treatment for miR-4295 detection. The expression of miR-4295 was observed after treatment, and the total clinical remission rate and adverse reactions after treatment were compared between the two groups. The tumor volume of the two groups was significantly reduced after treatment, with statistically significant difference (P<0.05); miR-4295 expression was reduced in the two groups (P<0.05); adverse reactions in propranolol group were less than pingyangmycin group during treatment (P<0.05). Propranolol and pingyangmycin, respectively, combined with pulsed dye laser had ideal efficacy on hemangioma in children. Moreover, miR-4295 was highly expressed in children with hemangioma, and the expression level reduced after two methods of treatment. However, adverse reactions in propranolol group were less and its safety was higher.