Abstract:Objective: To investigate the complications of integrated interventional treatment for mixed type of lower extremity deep vein thrombosis (LEDVT) and their management. Methods: The clinical data of 488 patients with acute or subacute mixed type LEDVT treared during 7 years were retrospectively analyzed. All patients underwent inferior vena cava filter placement, and subsequently underwent mechanical thrombus fragmentation and aspiration, catheter-directed thrombolysis and anticoagulant therapy. Intrapulmonary catheter-directed thrombolysis was performed in patients with symptomatic pulmonary embolism (PE), and balloon dilation angioplasty (percutaneous transluminal angioplasty, PTA) or post-PTA stent insertion was performed in patients with iliac vein stenosis or occlusion. Results: The incidence of symptomatic PE was 7.58% (37/488), and 2 of the PE patients (2/37) died in spite of aggressive salvage attempts. The incidence of vascular injury and large thrombus trapped by the filter during the integrated interventional treatment was 9.22% (45/488) and 16.60% (81/488), respectively. The incidence of abnormal bleeding during postoperative anticoagulation was 5.53% (27/488), and 2 of these patients died due to intracerebral hemorrhage. Four hundred and fifty-one patients were followed up for 4 to 94 months with average period of 41 months, during which time, the incidence of post-thrombotic syndrome (PTS) was 11.53% (52/451), and the incidence of post-PTA restenosis and reocclusion after stent placement was 40.19% (43/107) and 6.6% (7/106), respectively. Conclusion: Integrated interventional treatment for mixed type of LEDVT carries a certain risk of complications, so several preventive measures should be taken.