股静脉及胫前静脉入路导管接触溶栓治疗急性下肢深静脉血栓形成患者近期效果和安全性观察

The short-term efficacy and safety of catheter-directed thrombolysis via femoral vein and anterior tibial vein access for acute lower extremity deep vein thrombosis

目的评价股静脉入路及胫前静脉入路导管接触溶栓(CDT)治疗急性下肢深静脉血栓形成(LEDVT)患者近期效果和安全性。方法回顾性对照分析2019年1月至2021年12月在南京医科大学第二附属医院接受健侧股静脉人路及患侧胫前静脉入路CDT治疗的LEDVT患者临床资料。其中股静脉人路组40例,胫前静脉入路组46例。主要观察终点为手术技术成功率和血栓清除率,次要观察终点为手术时间和并发症。结果股静脉人路组、胫前静脉人路组手术技术成功率分别为92.5%、100%(P=0.097),血栓清除率分别为(68.9±25.9)%、(78.3±21.0)%(P=0.067),差异均无统计学意义;手术时间分别为(64.1±14.8)min、(72.0±19.9)min(P=0.037),差异有统计学意义;并发症发生率分别为22.5%、10.9%(P=0.145),差异无统计学意义。结论股静脉人路和胫前静脉人路CDT均可有效治疗LEDVT,近期疗效和安全性相当。

Objective To evaluate the short-term efficacy and safety of catheter-directed thrombolysis(CDT)via femoral vein access and via anterior tibial vein access for lower extremity deep vein thrombosis(LEDVT).Methods The clinical data of 86 LEDVT patients,who were treated with CDT via healthy-side femoral vein access or via affected-side anterior tibial vein access at the Second Affiliated Hospital of Nanjing Medical University of China between January 2019 and December 2021,were retrospectively analyzed.Of the 86 patients,via femoral vein access was adopted in 40(FV group)and via anterior tibial vein access was adopted in 46(ATV group).The primary endpoints were the technical success rate and the thrombus removal rate.The secondary endpoints included the operation time and the complications.Results In the FV group and ATV group,the technical success rates were 92.5%and 100%respectively(P-0.097),the thrombus removal rates were(68.9+25.9)%and(78.3±21.0)%respectively(P-0.067),and the differences between the two groups were not statistically significant.The operation time in the FV group and ATV group was(64.1±14.8)min and(72.0±19.9)min respectively(P=0.037),and the difference between the two groups was statistically significant.The incidence of complications in the FV group and ATV group was 22.5%and 10.9%respectively(P-0.145),and the difference between the two groups was not statistically significant.Conclusion CDT therapy,regardless of via femoral vein access or via anterior tibial vein access,can effectively treat LEDVT with quite same clinical short-term efficacy and safety.