Objective: To compare the efficacy of thrombus aspiration combined with catheter directed thrombolysis (CDT) and CDT alone in treatment of acute mixed lower extremity deep venous thrombosis (LEDVT).
Methods: The clinical data of 121 patients with acute mixed LEDVT treated during June 2012 to June 2017 were retrospectively analyzed. Of the patients, 60 cases underwent CDT after thrombus aspiration (thrombus aspiration plus CDT group) and 61 cases underwent direct CDT (CDT alone group). The main clinical variables between the two groups of patients were compared.
Results: The general preoperative data showed no significant differences between the two groups (all P>0.05). In thrombus aspiration plus CDT group compared with CDT alone group, the average length of hospital stay
(6.2 d vs. 10.5 d, P<0.05) and average amount of urokinase used (17×104 U vs. 290×104 U, P<0.05) were significantly reduced. In thrombus aspiration plus CDT group and CDT alone group, the cure rate and effective rate in thrombus aspiration plus CDT group on one week after treatment were 75% and 91.67% and on two weeks after treatment were 83.33% and 96.72%, and in CDT alone group on one week after treatment were 45.9% and 91.67% and on two weeks after treatment were 62.3% and 96.72%, respectively. The cure rates in thrombus aspiration plus CDT group were significantly higher than those in CDT alone group (both P<0.05), but the effective rates showed no significant differences between the two groups (both P>0.05). Follow-up was conducted at 12 months after operation, the incidence of complications, the decreasing amplitudes in differences in the circumferences at 15 cm below the knee between healthy and affected limb, the vein patency rates and normal venous valve function rates as well as the overall effective rates showed no significant differences between the two groups (all P>0.05).
Conclusion: Compared with CDT alone, thrombus aspiration plus CDT can obviously decrease the length of hospitalization, decrease the dose of urokinase infusion and increase the cure rate for acute mixed LEDVT, while its mid- and long-term efficacy shows no obvious superiority.