[Treatment of severe acute deep venous thrombosis in lower extremity].
OBJECTIVE
To explore the method and effectiveness of treatment for severe acute deep venous thrombosis (DVT) in lower extremity.


METHODS
Eighteen patients with severe acute DVT treated in our hospital from January 1, 2002 to December 31, 2008 were retrospectively analysed. All the patients had limb edema and pain, sixteen had limb cyanochroia(one had calf skin ulcer and foot gangrene), two had limb pallor, ten had weakened dorsalis pedis artery pulsation, eight had silent dorsalis pedis artery pulsation. Colour Doppler ultrasonography revealed DVT and superficial venous thrombosis in all diseased limbs. One patient underwent above knee amputation for limb gangrene. Seventeen underwent surgical thrombectomy, of which three were simple thrombectomy, five were supplemented with suprapubic saphenous vein bypass, six with suprapubic PTFE graft bypass, three with iliac vein lysis angioplasty.


RESULTS
One patient died (5.6%) on the third day after surgery. Limb edema relieved in seven patients (41.2%), reduced in ten patients (58.8%). All diseased limbs regained normal artery pulsation and skin appearance except for one limb amputated. Sixteen patients (94.1%) were followed up by a mean of 34 months. Limb edema disappeared in five patients (31.3%), reduced in eight patients (50%), recurrent in three patients (18.7%). Among three recurrent patients, one died of malignant tumor 9 months after operation, two had their graft occluded resulting from intimal hyperplasia.


CONCLUSIONS
Surgical thrombectomy is an effective method for treating severe acute DVT in lower extremity.
Gu
Yong-quan
YQ
Vascular Surgery Department of Xuan wu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China. gu-ya@263.net
Zhang
Jian
J
Qi
Li-xing
LX
Yu
Heng-xi
HX
Li
Xue-feng
XF
Guo
Lian-rui
LR
Chen
Bing
B
Cui
Shi-jun
SJ
Wu
Ying-feng
YF
Tong
Zhu
Z
Qi
Yi-xia
YX
Yang
Sheng-jia
SJ
Guo
Jian-ming
JM
Wang
Zhong-gao
ZG
D000208:Acute Disease; D000328:Adult; D000368:Aged; D016638:Critical Illness; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017131:Thrombectomy; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000601:surgery*