To analyze the treatment methods and efficacy of inferior vena cava filter thrombosis (IVCFT). In this retrospective study, the clinical data for 47 patients with IVCFT who underwent sequential treatment at the Department of Vascular Surgery, Tianjin Medical University Second Hospital, from January 2020 to January 2023 were analyzed. Patients were divided into three groups according to the treatment method: anticoagulant therapy (AC group), anticoagulation plus catheter-directed thrombolysis (CDT group), and anticoagulation plus AngioJet thrombectomy plus catheter-directed thrombolysis (PCDT group). The evaluation criteria for efficacy mainly included preoperative and postoperative clinical symptoms (Villalta score), thrombus diameter, thrombus clearance rate, filter retrieval rate, filter retention time, and urokinase dosage. This study included 47 patients, of whom 31 were males (65.9%) and 16 females (34.1%), with a mean age of 72.05 ± 8.32years. An Aegisy filter was used in seven patients, whereas an Illicium filter was used in forty patients. There were a total of nineteen patients in the anticoagulation-only group, with complete dissolution of the intraluminal thrombus in five patients, a residual thrombus with a maximum diameter ≤1cm in three patients, and a residual thrombus with a maximum diameter >1cm in eleven patients. The Villalta score was 7.16 ± 0.6 before treatment and decreased to 3.79 ± 0.59 after treatment. The thrombus diameter decreased from an average of 1.46 ± 0.2cm before treatment to an average of 0.85 ± 0.14cm after treatment. The retrieval rate for the filters was 42.11% (8/19), with an average dwell time of 27.4 ± 1.3days for the filters. The CDT group consisted of 17 patients. Among whom we observed, complete dissolution of the intraluminal thrombus was observed in six patients, residual thrombus with a maximum diameter ≤1cm in nine patients, and residual thrombus with a maximum diameter >1cm in two patients. The Villalta score decreased from 7.53 ± 0.83 before treatment to 2.06 ± 0.39 after treatment. The thrombus diameter also decreased from 1.46 ± 0.16cm before treatment to 0.35 ± 0.11cm after treatment. The retrieval rate of the filters was 88.24% (15/17), and the average filter indwelling time was 19.25 ± 4.5days. The PCDT group consisted of 11 patients. We observed complete dissolution of the intraluminal thrombus in four patients, residual thrombus with a maximum diameter ≤1cm in six patients, and residual thrombus with a maximum diameter >1cm in one patient. The Villalta score decreased from 7.45 ± 0.76 before treatment to 2.09 ± 0.55 after treatment. The thrombus diameter decreased from 1.50 ± 0.21cm before treatment to 0.33 ± 0.35cm after treatment, and the rate of filter retrieval was 90.91% (10/11). The three treatments of anticoagulation therapy, CDT, and PCDT were meaningful for preoperative and postoperative thrombolysis and symptom improvement in patients with IVCFT. The application of CDT and PCDT was superior to anticoagulation therapy, while there was no significant difference between the CDT and PCDT group. The retrieval rate of filters in the anticoagulation therapy group was the lowest, with no significant difference between the CDT and PCDT group.
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