Objective: To investigate the short- and long-term efficacy of catheter-directed thrombolysis (CDT) combined with iliac vein stenting for patients with Cockett syndrome and concomitant lower extremity deep vein thrombosis (DVT). 
Methods: Ninety patients with Cockett syndrome and DVT admitted from January 2013 to January 2015 were randomly assigned to observation group and control group by the random number table, with 45 cases in each group. Patients in observation group underwent CDT plus stenting, and those in control group underwent CDT alone. The short- and long-term efficacy, severities of vascular injury and changes in inflammatory factors between the two groups were compared.
Results: There was no significant difference in postoperative efficacy between the two groups (H=0.518, P=0.604). All patients were followed up for 36 to 40 months, and no stent fracture, displacement, collapse, disintegration or perforation was noted. In observation group, the re-occlusion rate was lower (11.1% vs. 37.8%, P<0.05) and the primary patency rate (88.9% vs. 62.2%, P<0.05) was higher than those in control group. The Villalta score and VCSS score were significantly lower and the CIVIQ score was significantly higher in observation group than those in control group at the last follow-up (all P<0.05). The postoperative vascular injury score and serum TNF-α and IL-10 levels in both groups were significantly increased compared with their preoperative values, but their increasing amplitudes in observation group were significantly greater than those in control group (all P<0.05). The vascular injury score and serum TNF-α and IL-10 levels in patients with re-occlusion were significantly higher than those without re-occlusion in observation group (all P<0.05), which showed no significant differences between patients with and without re-occlusion in control group (all P>0.05). There was no significant difference in incidence of adverse reactions between the two groups (P>0.05).
Conclusion: For patients with Cockett syndrome and lower limb DVT, the short-term efficacy of CDT plus iliac vein stenting is similar to that of CDT alone, but its long-term efficacy is better than CDT alone. Re-occlusion after CDT plus stenting may be associated with inflammatory factor release and vascular injury induced by stent implantation.