Mechanical thrombectomy with AngioJet compared with catheter-directed thrombolysis for treatment of lower extremity deep venous thrombosis

Abstract

Objective To compare the treatment outcomes in patients with lower extremity deep venous thrombosis (DVT) who underwent either catheter-directed thrombolysis (CDT) or percutaneous mechanical thrombectomy (PMT) intervention. Methods A retrospective analysis of clinical records of all patients with lower extremity DVT (n=48) in our center from December 2013 to December 2015 was undertook. All patients underwent PMT treatment with AngioJet (PMT group, n=24) or CDT treatment (CDT group, n=24). Results In PMT group, complete thrombolysis was found in 20 cases (83.3%) with grade Ⅲ, 3 with gradeⅡ (12.5%) and 1 with gradeⅠ (4.2%) , respectively. And in CDT group, it was 19 (79.1%) , 4 (16.7%) and 1 (4.2%) , respectively. There were no significant differences of the thrombolysis outcomes between two groups (P=0.919). No significant differences of the clinical symptomatic improvement were found between two groups (21 vs. 18, P=0.461). The procedural time was shorter in the PMT group (0.25 ± 0.11 h) compared with CDT group [(45.68 ± 8.25) h, P<0.001]. Urokinase dose was lower in the PMT group than CDT group [(16.7 ± 3.20) million units vs. (144±20.37) million units, P<0.001]. There were no major complications in the both groups. Subcutaneous congestion around puncture site, catheter infection and blood platelet reduction occurred in 3, 1 and 1 patient, respectively. The thigh and calf circumferences of CDT group decreased more than PMT group, but with no significant statistical differences [(4.98±3.38) cm vs. (4.11±1.71) cm, P=0.424; (4.52±2.14) cm vs. (3.72±1.25) cm, P=0.272]. Conclusion PMT with the AngioJet device for lower extremity DVT requires shorter procedure time and lower urokinase doses than conventional CDT, while providing the same results. Key words: Deep venous thrombosis; Mechanical thrombectomy; Catheter-directed thrombolysis