Endovascular treatment of lower extremity deep venous thrombosis

Abstract

Objective To evaluate the endovascular treatment of deep venous thrombosis (DVT)by surgery combined with intervention.Method This study enrolled 76 patients with lower extremity deep venous thrombosis.Under the surveillance of DSA(digital subtraction angiography),inferior vena cava filter was first placed,then surgical thrombectomy,combined with a temporary femoral artery and vein fistula were performed accordingly.Angiography was followed immediately to observe whether there were residual thrombosis and iliac vein lesions.For the removal of residual thrombus,double-lumen tube thrombectomy or large bore sheath suck thrombectomy were applied.In cases in which iliac vein stenosis was greater than 60%,an angioplasty is indicated,in which iliac vein stent placement was performed in 62 cases.ResultStent implantation technical success rate was 100% ,one patient died of rupture of ascending lumbar vein.71 patients were followed up,in which 60 patients with iliac vein stent.After a follow-up of 3-30 months (averaged at 21 months),lower limb swelling significantly eased in 65 patients.Six cases suffered from recurrent thrombosis (8.45%,6/71) in which thrombosis found in the stent in 4 cases (6.66%,4/60),stent displacement found in 6 cases (10.0%,6/60),stent fracture in 1 case (1.66%,1/60).Conclusion Under the surveillance of DSA,thrombectomy combined with iliac vein stent improves vein patency rate,which is the mainstay of the treatment for lower extremity deep venous thrombosis. Key words: Venous thrombosis; Angioplasty; Venous thrombectomy