导管溶栓治疗急性下肢深静脉血栓37例分析-ChineseMedicalJournal.docVIP

Prospective Study - Stenting of iliac vein obstruction following catheter directed thrombolysis in Lower Extremity Deep Vein Thrombosis Keywords: deep venous thrombosis; catheter directed thrombolysis; stent Objective: The goal of this study was to evaluate the efficacy of stent placement in the iliac vein following catheter-directed thrombolysis (CDT) in lower extremity deep vein thrombosis (DVT). Methods: This was a single-center, prospective, randomized controlled clinical trial. After receiving CDT, the major branch of the distal iliac vein was completely patent in 155 patients with lower extremity DVT, and 74 of these patients with iliac vein residual stenosis 50% were randomly divided into a control group (n=29) and test group (n=45). In the test group, stents were implanted in the iliac vein, whereas no stents were implanted in the control group. We evaluated the clinical indicators including patency of the deep vein, C in CEAP classification, venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ) score. Results: All patients had postoperative follow-up visits for a period of 6 to 24 months. Venography or color ultrasound was conducted in 40 test-group and 27 control-group subjects. There was a significant difference in the patency rate at the last follow-up visit between the test and control groups [87.5% (35/40) vs 29.6% (8/27), P0.05]. The 1-year patency rate was significantly different between the test and control groups (86.0% vs 54.8%, P0.01). The change in the C in CEAP classification pre- and post-procedure was significantly different between the test and control groups (1.61±0.21 vs 0.69±0.23, P0.01). In addition, at the last follow-up visit, VCSS and CIVIQ scores were both significantly different between the test and control groups (7.57±0.27 vs 0.69±0.23. P0.01; 22.67±3.01 vs 39.34±6.66, P0.01, respectively). Conclusion: This pilot study suggests that the stenting of iliac vein obstruction following CDT in l