title: [Efficacy comparison of interventional treatment by anterograde or retrograde catheterization for acute lower extremity deep venous thrombosis].
abstract: Objective:To compare the clinical efficacy differences between anterograde and retrograde catheterization interventional treatment for acute low extremity deep venous thrombosis(DVT).Methods:The clinical data of 217 patients with acute low extremity DVT between January 2009 and December 2014 were analyzed retrospectively. Group A: 67 patients underwent treated with anterograde catheterization interventional treatment. Group B: 150 patients underwent treated with retrograde catheterization interventional treatment. The degree of thrombolysis in different anatomical sites, clinical effective rate, femoral-popliteal vein valve reflux and the incidence of post-thrombotic syndrome(PTS) were all analyzed.Results:There were no statistical differences in the degree of thrombolysis (≥50%) of common iliac vein, external iliac vein and common femoral vein between group A (83.6%, 88.1%, 91.0%)and B (80.7%, 82.0%, 88.0%)(allP>0.05). The degree of thrombolysis (≥50%) of superficial femoral vein in group A(94.0%) was significantly higher than that of group B (75.3%)(P=0.001). There was no significantly difference in the clinical effective rate at discharged between group A (80.6%) and B(76.7%)(P=0.519). During follow-up of 44±15 months, There was no statistical difference in the patency rate of the iliofemoral vein, the valvular regurgitation of patent femoropopliteal vein and the incidence of PTS between group A(70.2%, 25.4%, 35.8%) and B (60.0%, 31.5%, 40.0%)(allP>0.05). The incidence of PTS in patients with iliofemoral vein patency(13.1%) was significantly lower than that in patients with iliofemoral vein occlusion (82.5%)(P<0.01).Conclusions:The anterograde or retrograde catheterization interventional treatment can be used for treating acute low extremity DVT and get comparable clinical effect.The retrograde catheterization does not increase venous valve damage. The recovery of iliofemoral vein lumen patency is the main task in the treatment of DVT and can significantly reduce the incidence of PTS.
authors.affiliation: Department of Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
authors.forename: G P
authors.initials: GP
authors.lastname: Chen
authors.forename: J P
authors.initials: JP
authors.lastname: Gu
authors.forename: X
authors.initials: X
authors.lastname: He
authors.forename: W S
authors.initials: WS
authors.lastname: Lou
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.forename: H B
authors.initials: HB
authors.lastname: Su
authors.forename: W Y
authors.initials: WY
authors.lastname: Shi
authors.forename: T
authors.initials: T
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D002406:Catheterization, Peripheral; D005268:Femoral Vein; D006801:Humans; D007084:Iliac Vein; D015994:Incidence; D035002:Lower Extremity; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D020246:Venous Thrombosis; D055422:Venous Valves
keywords: Catheterization; Comparative study; Venous thrombosis