Manual aspiration thrombectomy for acute and subacute inferior vena cava thrombosis and lower extremity deep venous thrombosis

Deep vein thrombosis(DVT), which can lead to pulmonary embolism(PE), is a major contributor to the global disease burden and is the third most common cardiovascular pathology after coronary artery disease and stroke. Venous thromboembolic disease, which encompasses the disease entities of DVT and PE, affects up to 10 million cases every year and represents a serious and potentially life-threatening condition. Standard anticoagulation therapy alone is ineffective at promoting deep venous system thrombus removal. Many patients develop postthrombotic syndrome(PTS) despite being on adequate anticoagulation therapy. Aggressive therapy for rapid thrombus removal is important to prevent the development of PTS. Besides impeding the onset of PTS, rapid clearance of the thrombus is also required in the treatment of phlegmasia cerulea dolens, an uncommon but life-threatening complication of acute DVT that can lead to arterial insufficiency, compartment syndrome, venous gangrene, and limb amputation. Manual aspiration thrombectomy(MAT) can provide rapid and effective therapy that could be compared to the open surgical thrombectomy approach with minimal risk of morbidity, mortality, or recurrence after surgery. Though many devices have been developed to date for pharmacomechanical thrombolysis, the cost of the treatment using these devices is very expensive. MAT is simple to perform, easy to learn, inexpensive, and rapid. This review will outline and dissect several studies and case reports, sourced from the Pub Med database, on the subject of the use of MAT in treating inferior vena cava thrombosis and lower extremity DVT, including in patients with compression of the iliac vein and phlegmasia cerulea dolens.

Deep vein thrombosis in patient with left-sided inferior vena cava draining into the hemiazygos vein: A case report

BACKGROUND Abnormalities of the inferior vena cava(IVC)are uncommon,and in many cases they are asymptomatic.Even so,it is vital that clinicians be aware of such anomalies prior to surgery in affected individuals.In the present report,we describe a rare anatomical variation of the IVC.CASE SUMMARY A 66-year-old male was admitted to the hospital due to deep vein thrombosis of the right lower extremity.Upon contrast-enhanced computed tomography imaging,we found that this patient presented with a case of left-sided IVC draining into the hemiazygos vein,while his hepatic vein was directly draining into the atrium.CONCLUSION Cases of left-sided IVC can increase patient susceptibility to thromboembolism owing to the resultant changes in blood flow and/or associated vascular compression.

High Inferior Vena Cava Thrombosis in a 16-year-old Postpartum Patient:A Case Report

Postpartum inferior vena cava (IVC) thrombosis is a rare,but potentially life-threatening disorder.Here we reported one case of the youngest woman to date who presented with massive IVC thrombus extending from deep veins of the right leg to the level of the 11th thoracic vertebra,associated with asymptomatic pulmonary embolism.

Surgery for hepatocellular carcinoma with tumor thrombosis in inferior vena cava: A case report

BACKGROUND Hepatocellular carcinoma(HCC)accompanied by a tumor thrombus is very common.However,the treatment strategy is controversial and varies by the location of the thrombus.CASE SUMMARY We report herein a case of HCC with a tumor thrombus in the suprahepatic inferior vena cava(IVC),which was successfully treated by hepatectomy combined with thrombectomy following sorafenib chemotherapy.A 47-year-old woman with chronic hepatitis was diagnosed with HCC.Computed tomography and magnetic resonance imaging showed that the tumor lesion was located in the right half of the liver,and a tumor thrombus was detected in the suprahepatic IVC near the right atrium.After multi-departmental discussion and patient informed consent,right major hepatectomy and total removal of the tumor thrombus were successfully performed under cardiopulmonary bypass.There were no serious complications after surgery.Following sorafenib treatment,no recurrence has been detected so far(11 mo later).CONCLUSION Surgical treatment followed by adjuvant sorafenib therapy might be an acceptable choice for HCC patients with tumor thrombosis in the IVC.

Pediatric Pancreatic Lymphadenitis Tuberculosis Causing Inferior Vena Cava Thrombosis in Syria

Background: Pancreatic tuberculosis (TB) is very rare, mostly due to the antibacterial effects of the pancreatic enzymes. The association of thrombosis and tuberculosis has been reported but that of inferior vena cava (IVC) thrombosis and pancreatic tuberculosis is extremely rare and has only been reported once. Case presentation: A case of pancreatic Tuberculosis and IVC thrombosis presented with constitutional symptoms. Ultrasonography and computerized tomography showed a lesion in the head of the pancreas and a large lymph mass. Magnetic resonance imaging (MRI) of (IVC) showed thrombosis in the IVC. Histological examination revealed necrotizing granulomas after a laparotomy. The patient received antituberculosis chemotherapy and low molecular weight heparin. Conclusion: Pancreatic TB is a challenge to diagnose especially in Resource-poor countries, which might lead to delay in treatment and worse complications.

A Case Report and a Descriptive Retrospective Study of Cases of Inferior Vena Cava Thrombosis Diagnosed over a 10-Year Period in a Third Level Hospital

Inferior vena cava thrombosis is an under-recognized entity associated with significant morbidity and mortality. This is the reason why, although the diagnosis is challenging, a high index of suspicion is required. Regarding this condition, we present the case of a 63-year-old man who had repeatedly visited the emergency room suffering from abdominal and back pain and painful lower limb edema. After several tests, including magnetic resonance imaging (MRI), he was diagnosed to have agenesis of left renal vein and inferior vena cava thrombosis, from hypercoagulable state secondary to Antiphospholipid Syndrome. He had anticoagulation treatment with low-molecular-weight heparin with good subsequent evolution. This study sets out a descriptive retrospective study of fifty cases of inferior vena cava thrombosis diagnosed in a third-level hospital in the north of Spain over a ten-year period (2010-2018). The aim of this article is to identify the epidemiology, predisposing factors and symptoms that characterize this entity, in order to be able to achieve an early diagnosis that allows us to initiate immediate treatment, minimizing acute and chronic complications of this disease.

Retroperitoneal hematoma after implantation of double inferior vena cava filters

A 55-year-old man developed deep venous thrombosis and inferior vena cava(IVC) thrombosis 7 years earlier and was treated by placement of a permanent IVC filter. One week ago, he was admitted with bilateral lower limb swelling and pain. Digital subtraction angiography showed a filling defect above the original filter. A retrievable Tulip filter was placed and catheter-directed thrombolysis was performed. Six days later, the patient experienced sudden, persistent upper right abdominal pain, and a computed tomography scan revealed the formation of retroperitoneal hematoma. Symptomatic treatments were administered, and the hematoma gradually resolved during follow-up.

Clinical outcomes of Angio Jet pharmacomechanical thrombectomy versus catheter-directed thrombolysis for the treatment of filter-related caval thrombosis

BACKGROUND The inferior vena cava filter is utilized worldwide to intercept thrombi and to reduce the risk of fatal pulmonary embolism(PE).However,filter-related thrombosis is a complication of filter implantation.Endovascular methods such as AngioJet rheolytic thrombectomy(ART)and catheter-directed thrombolysis(CDT)can treat filter-related caval thrombosis,but the clinical outcomes of both treatment modalities have not been determined.AIM To compare the treatment outcomes of AngioJet rheolytic thrombectomy vs catheter-directed thrombolysis in patients with filter-related caval thrombosis.METHODS In this single-center retrospective study,65 patients(34 males and 31 females;mean age:59.0±13.43 years)with intrafilter and inferior vena cava thrombosis were enrolled between January 2021 and August 2022.These patients were assigned to either the AngioJet group(n=44)or the CDT group(n=21).Clinical data and imaging information were collected.Evaluation measures included thrombus clearance rate,periprocedural complications,urokinase dosage,incidence of PE,limb circumference difference,length of stay,and filter removal rate.RESULTS Technical success rates were 100%in the AngioJet and CDT groups.In the AngioJet group,grade II and grade III thrombus clearance was achieved in 26(59.09%)and 14(31.82%)patients,respectively.In the CDT group,grade II and grade III thrombus clearance was accomplished in 11(52.38%)patients and 8(38.10%)patients,respectively(P>0.05).The peridiameter difference of the thigh was significantly reduced in patients from both groups after treatment(P<0.05).The median dosage of urokinase was 0.08(0.02,0.25)million U in the AngioJet group and 1.50(1.17,1.83)million U in the CDT group(P<0.05).Minor bleeding was shown in 4(19.05%)patients in the CDT group,and when it was compared with that in the AngioJet group,the difference was statistically significant(P<0.05).No major bleeding occurred.Seven(15.91%)patients in the AngioJet group had hemoglobinuria and 1(4.76%)patient in the CDT group had bacteremia.There were 8(18.18%)patients with PE in the AngioJet group and 4(19.05%)patients in the CDT group before the intervention(P>0.05).Computed tomography angiopulmonography(CTA)showed that PE was resolved after the intervention.New PE occurred in 4(9.09%)patients in the AngioJet group and in 2(9.52%)patients in the CDT group after theintervention(P>0.05).These cases of PE were asymptomatic.The mean length of stay was longer in the CDT group(11.67±5.34 d)than in the AngioJet group(10.64±3.52 d)(P<0.05).The filter was successfully retrieved in the first phase in 10(47.62%)patients in the CDT group and in 15(34.09%)patients in the AngioJet group(P>0.05).Cumulative removal was accomplished in 17(80.95%)out of 21 patients in the CDT group and in 42(95.45%)out of 44 patients in the ART group(P>0.05).The median indwelling time for patients with successful retrieval was 16(13139)d in the CDT group and 59(12231)d in the ART group(P>0.05).CONCLUSION Compared with catheter-directed thrombolysis,AngioJet rheolytic thrombectomy can achieve similar thrombus clearance effects,improve the filter retrieval rate,reduce the urokinase dosage and lower the risk of bleeding events in patients with filter-related caval thrombosis.

Comparative outcomes of Inferior Vena Cava filters placed at bedside using digital radiography versus conventional fluoroscopy

Purpose:To retrospectively assess the outcomes of Inferior Vena Cava(IVC)filters placed in critically ill patients in the ICU at bedside using digital radiograph(DR)guidance with previous cross-sectional imaging for planning,compared to IVC filters placed by conventional fluoroscopy(CF).Method and materials:The cohort consisted of 129 IVC filter placements;48 placed at bedside and 81 placed conventionally from July 2015 to September 2016.Patient demographics,indication,radiation exposures,access site,procedural duration,dwell time,and complications were identified by the EMR.IVC Filter positioning with measurements of tip to renal vein distance and lateral filter tilt were performed when cavograms or post placement CTs were available for review.Statistical analysis was performed using Stata IC 11.2.Results:Technical success of the procedure was 100% in both groups.Procedural duration was longer at the bedside lasting 14.5+/-10.2 versus 6.7+/-6.0 min(p<0.0001).The bedside DR group had a median radiation exposure of 25 mGy(15-35)and the CF group had mean radiation exposure of 256.94 mGy+/-158.6.There was no significant difference in distance of IVC tip to renal vein(p=0.31),mispositioning(p=0.59),degree of filter tilt(p=0.33),or rate of complications(p=0.65)between the two groups.Conclusion:IVCF placement at the bedside using DR is comparable to CF with no statistical difference in outcomes based on IVCF positioning,degree of lateral tilt or removal issues.It decreased radiation dose,but with overall increased procedural time.

Utility of the Inferior Vena Cava Diameter as a Marker of Dry Weight in Nonoliguric Hemodialyzed Patients

We have previously reported that the maximal inferior vena cava(IVC) diameter during quiet expiration(IVCe) measured by ultrasonography correlates well with the amount of body fluid, especially the circulating blood volume[1] and proposed using the criteria of IVC diameter to determine dry weight(DW) in anuric hemodialyzed (HD) patients: standard IVCe of pre-and post-HD are (14.9±0.4) and (8.2±0.3) mm, respectively[2]. However, the same post-HD IVC criterion should not be applied to nonoliguric HD patients because it could result in rapid deterioration of residual renal function due to forced dehydration. Although the biochemical DW marker plasma atrial natriuretic peptide (ANP) is useful to evaluate hypervolemia but not hypovolemia,both hyper-and hypovolemia can be detected by IVC measurement.……

The Inferior Vena Cava Diameter as a Marker of Dry Weight in Chronic Hemodialyzed Patients(续)

The IVC diameters in HD patients Since BW and stature as well as gender and age were not considered to be determinant factors of the IVC diameters, these factors were not accounted for in evaluating the IVC diameters in HD patients. The IVC diameters of stable anuric HD patients are shown in Table 2. In agreement with our previous observation [7-9] ,the reduction of BW from (51.7±12.6) to (49.3±12.6)kg by ultrafiltration during HD resulted in a significant (P<0.0001)reduction of the IVCe and IVCi from (14.9 ± 3.2) to (6.8±1.9)mm and (5.2±4.2) to (0.1±0.3) mm,respectively. Thus,CI values before and at the end of HD were calculated as (0.68±0.24) and (0.98±0. 05), respectively (P<0.0001). ……

Fracture Rate and Serious Complications of Vena Cava Filters

Purpose: To retrospectively evaluate the prevalence of fracture and fragment embolization of inferior vena cava (IVC) filters. Methods: Electronic medical records and imaging studies of all Kaiser Permanente patients who received IVC filters from August 2000 until August 2010 were retrospectively reviewed for filter complications. Results: 283 patients received an IVC filter during the study period. 143 patients were deceased, while 140 are living. Among deceased patients, the average age at the time of death was 69.8 ± 15.3 [range: 24.7 - 99.2] years;55.9% were men;the mean implantation-to-image time was 13.6 ± 20.6 [range: 0 - 92.4] months, and there were no reported major complications attributable to filter migration or fracture at a mean of 16.8 ± 24.8 [range: 0 - 119.6] months following implantation. One of 14 (7.1%) G2 filters perforated the aorta, which already had a stent graft in place. Among those patients still living, the average age was 67.3 ± 15.2 [range: 15.2 - 97.3] years, 47.1% were men, the mean implantation-to-image time was 33.3 ± 36.5 [range: 0.1-141.7] months, and there were no reported major complications at a mean of 35.3 ± 36.5 [range: 0 - 141.7] months following implantation. Three of 60 (5.0%) Trapease filters were found to have at least 1 strut fracture. There were no cases of filter migration or fragment embolization. The overall fracture rate of all filters with an implantation-to-image-time greater than two years (mean implantation-to-image time 4.7 ± 2.7 [range: 2.0 - 11.8] years) was 3 of 67 (4.5%). Bard G2 and G2X filters had a 0% fracture and embolization rate at a mean of 19.0 ± 16.6 [range: 0.07 - 49.5] months after implantation. Conclusions: IVC filters, regardless of type, have a low prevalence of fracture and we found no cases of fragment embolization.

Fatal thrombotic complications of hepatic cystic compression of the inferior vena: A case report

Of 5% of patients who develop liver cysts, only 10-15%of them come for medical attention, typically because of dull right upper quadrant pain, abdominal bloating or early satiety. We treated a 77-year-old female with a rare complication of inferior vena cava thrombosis. The patient expired due to septic shock and multiple organ failure.

Treatment of deep vein thrombosis (DVT) around renal vein

Objective To study and evaluate the treatment of the deep vein thrombosis(DVT) around the renal vein(DVT involving the renal vein and it's surrounding,shortly as DVTAR in our study)by two-positioned filter for catheter thrombectomy assisted with a Fogarty balloon.Methods We retrospectivly analysed seven cases of DVTAR and by comparison to elicit the respective effect different methods in DVT treatment.The methods used were:1.direct thrombectomy 2.thrombectomy facillitated by blocking of blood flow with a balloon 3.direct thrombolysis via Peripheral vein and 4.thrombectomy with simultaneous placement of a two-positioned filter with a Fogarty balloon and followed by intubation thrombolysis.Result Segmental pulmonary embolism(PE)or thrombosis in vena cava were still observed by CT angiography(CTA)or venography in those cases treated with the first three methods.As for the 3 cases where two-positioned filter for catheter thrombectomy with Fogarty balloon was used,neither pulmonary embolism during and after the operation nor thrombosis in the inferior vena cava was observed.Conclusion For DVTAR,thrombectomy with simultaneous placement of a two-positioned filter with a Fogarty balloon and followed by intubation thrombolysis can be regarded as safe and effective.

植入放射性支架联合经动脉化疗栓塞(TACE)治疗肝恶性肿瘤合并下腔静脉(IVC)梗阻

目的探讨植入携带粒子条支架及经动脉化疗栓塞（transarterial chemoembolization,TAcE）联合治疗肝恶性肿瘤伴下腔静脉（inferior vena CaV＆，IvC）梗阻的安全性及疗效。方法对2008年7月至2013年6月共97例在我院接受介入治疗的肝恶性肿瘤伴下腔静脉梗阻患者的资料进行回顾性分析。在所有患者下腔静脉梗阻段植入携带粒子条支架，同时对肝内病灶进行化疗栓塞治疗。对下腔静脉症状缓解率、支架通畅性、生存期及预后因素进行分析。结果下腔静脉支架及粒子条植入手术成功率为100％；IVC支架通畅率为98％，下腔静脉梗阻症状缓解率为98％；患者平均生存时间为（277．6±251．4）天，中位生存期为（203．0±251．3）天；在随访期2～36个月期间支架通畅率为98％。结论植入携带粒子条支架联合经动脉化疗栓塞治疗肝恶性肿瘤伴下腔静脉梗阻患者安全可行，疗效好。

恶性肿瘤合并下腔静脉(IVC)栓子行栓子活检术的临床意义

目的评价对恶性肿瘤合并下腔静脉(inferior vena cava,IVC)栓子患者行栓子活检术的临床意义。方法对14例恶性肿瘤合并IVC栓子患者经右侧股静脉行IVC栓子活检。记录取出标本的成功率和患者术中及术后的不良反应或并发症,并随访2个月了解是否引起医源性肺部转移。分析病理结果,与术前CT或MRI诊断进行比较,判断影像诊断的准确率。结果 IVC栓子活检术成功率为100%,患者术中及术后未出现急性肺栓塞(pulmonary embolism,PE)及IVC破裂出血,随访2个月未发现医源性肺转移。术前影像学诊断与病理结果的符合率较高,达93%。结论恶性肿瘤合并IVC栓子行栓子活检术是安全、微创、易行的,能为进一步治疗提供病理学依据。

IVC-RVI联合血清炎症因子水平预测脓毒症休克患者容量反应性的价值

目的 探讨下腔静脉内径呼吸变异度(IVC-RVI)联合血清炎症因子水平预测脓毒症休克患者容量反应性的临床价值。方法 选取锦州市中心医院2019年6月—2021年6月120例脓毒症休克患者作为研究对象,根据容量负荷试验将患者分为有反应组(n=52)和无反应组(n=68)。于容量负荷试验前采用超声测定患者吸气末下腔静脉最大内径(D_(max))、呼气末下腔静脉最小内径(D_(min)),计算IVC-RVI。于患者入院时测定血清炎症因子[白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]。借助ROC分析D_(max)、D_(min)、IVC-RVI、IL-6、CRP、TNF-α对脓毒症休克患者有容量反应性的预测价值,通过一致性分析,评估D_(max)、D_(min)、IVC-RVI联合IL-6、CRP、TNF-α对脓毒症休克患者有容量反应性的预测价值。结果 有反应组D_(max)、D_(min)显著低于无反应组,IVC-RVI显著高于无反应组,比较差异有统计学意义(P<0.05)。有反应组血清IL-6、CRP、TNF-α水平均显著低于无反应组,比较差异有统计学意义(P<0.05)。经ROC分析,D_(_(max))、D_(min)、IVC-RVI、IL-6、CRP、TNF-α预测脓毒症休克患者有容量反应性的曲线下面积分别为0.836、0.846、0.804、0.903、0.877、0.756,均有P<0.05。经一致性分析,120例脓毒症休克患者中联合预测阳性51例,敏感度为0.981,特异性为0.971,准确率为0.975,Kappa为0.949。结论 IVC-RVI和血清炎症因子水平均可用于脓毒症休克患者容量反应性预测中,且联合检测可获得更好的敏感度、特异性。

Insights into treatment for hepatocellular carcinoma with tumor thrombus in the inferior vena cava or right atrium

Hepatocellular carcinoma(HCC),one of the most common liver cancers,often has a poor prognosis when it involves macrovascular invasion.Oncological emergencies including pulmonary embolism,heart failure,and even sudden death could happen when it develops a tumor thrombus(TT)in the inferior vena cava(IVC)or right atrium(RA),indicating an exceptionally grim prognosis(1).Although systemic therapy is the only standard treatment recommended by guidelines(2),other treatment modalities are explored including surgery,radiotherapy,etc.in some centers.Surgery,as the only potential curative treatment,has been explored in several selected cases.A case of long-term survival of 15 years and cancer-free survival of 9 years was reported by surgical resection with a heart-first approach under cardiopulmonary bypass(CPB)(3),suggesting that aggressive surgery together with multidisciplinary treatments might achieve long survival.However,due to the aggressiveness and challenge of surgical resection-massive resection area,potential significant blood loss,and bypass needed,surgical resection is applied in very limited centers.Nevertheless,safety,efficacy,and long-term survival benefits for these patients are poorly investigated.

Digital radiograph(DR)guided bedside IVC filter placements in patients with intracranial pressure monitors

Purpose:The purpose of this study is to report a single center experience with portable digital radiographically(DR)guided bedside IVC filters placed in intensive care unit(ICU)patients with high ICP and elevated head of bed(HOB).Materials and methods:A retrospective chart review was conducted on all bedside IVC filters placed from January 1,2010 to September 16,2020.Patients with high ICP and elevated head of bed requirements were included.Charts were reviewed for filter type,common femoral vein(CFV)access,filter location,pre procedure imaging,pre and post filter ICPs,glascow coma scale,number of radiographs taken,and filter removal.ICPs were obtained 1 h prior to procedure and 2 h post procedure and analyzed with a paired T test.Filters were placed by reviewing prior CT scan for IVC size,caval variants,renal and iliac veins and vertebral body landmarks.Then,CFV access was obtained and a Bentson wire was advanced 30-40 cm.A radiograph was used to confirm adequate position of the of the wire.The filter sheath was advanced and serial radiographs were used to position the filter sheath at the final predetermined position below the renal veins and above the iliac bifurcation.The filter was deployed,and a radiograph was obtained to confirm filter positioning.Results:A total of 9 DR guided bedside IVC filters were placed(4 Denali,3 Option Elite,2 Celect).Indications included prophylactic placement(n=8)and acute DVT(n=1).The average patient age was 35.8 years(range:18-56 years)CT abdomen and pelvis was used to assess for the level of renal veins in all patients(n=9).No caval variants were encountered on pre-procedural planning.The average pre,intraprocedural,and post procedure intracranial pressure was 16 mmHg,13 mmHg,and 16 mmHg,respectively.Confirmation of placement after final placement was available in 7 patients(4 DR,2 CT and one fluoroscopic examination).Two non-procedural related deaths occurred.Technical success,defined as successful placement of IVC filter at the predetermined level,was achieved in 100%of patients(n=9).The right CFV was used in most patients(n=7).The left CFV was used for access in two patients due to right CFV thrombus(n=1)and existing right femoral venous central line(n=1).The average number of radiographs taken was 5.8(range 4-9).In all cases,filters were placed below the level of the lowest renal vein(n=9).A comparison of pre,during and post intervention ICP pressures is shown in table,2.No differences between pre and post filter ICP was noted(p=0.77).Three filters were later removed.One minor complication was reported,which was filter tilt(23%)in an Option filter.Conclusion:Bedside IVC filters can be safely placed in patients with head trauma and high ICP who are unable to lay supine using portable DR guidance with a high rate of technical success and minimal complications.

分期递增式球囊扩张术治疗布加综合征合并下腔静脉血栓的临床疗效及安全性分析

目的探讨分期递增式球囊扩张术治疗布加综合征(BCS)合并下腔静脉血栓的临床疗效及安全性。方法62例BCS合并下腔静脉血栓患者,均使用分期递增式球囊扩张术进行治疗。分析治疗结果(小球囊预开通成功率、血栓溶解率、并发症发生情况及死亡情况);比较手术前后实验室指标[白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(Hb)、白蛋白(ALB)、血小板计数(PLT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、直接胆红素(DBil)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]。结果62例患者中,小球囊预开通成功率为61例(98.39%),有1例因下腔静脉长段闭塞而反复扩张无法开通;其中,新鲜血栓25例,均行经导管溶栓后清除,其余为陈旧性血栓,在1个月内完全溶解率为93.44%(57/61);所有患者围术期均未发生无症状性肺栓塞、死亡病例。患者术后PLT(131.65±37.02)×10^(9)/L、HDL-C(1.15±0.21)mmol/L均高于术前的(108.94±46.36)×10^(9)/L、(0.93±0.28)mmol/L,ALP(88.19±40.63)U/L、DBil(21.02±7.59)μmol/L均低于术前的(111.57±57.48)U/L、(24.89±9.98)μmol/L(P<0.05);手术前后WBC、RBC、Hb、ALB、ALT、AST、TC水平相比无明显差异(P>0.05)。结论在BCS合并下腔静脉血栓患者的治疗中,分期递增式球囊扩张术的临床疗效显著,手术成功率及血栓溶解率高,并发症发生率低,能有效调节PLT、HDL-C等水平,对改善预后有积极意义。