Comparison of Effect and Safety of CDT Combined with Stent Implantation and System Thrombolysis in the Treatment of IVCS with Lower Extremity DVT
Objective:To explore and compare the effect and safety of catheter-directed thrombolysis(CDT)combined with stent implantation and system thrombolysis in the treatment of iliac vein compression syndrome(IVCS)with deep venous thrombosis(DVT)of lower extremities.Method:A total of 70 patients with IVCS complicated with lower extremity DVT admitted to Xinyu People's Hospital from June 2020 to June 2022 were selected as the study subjects,and they were divided into non-surgical group and surgical group by random number table method with 35 cases in each group.The non-surgical group was treated with system thrombolysis,and the surgical group was given CDT combined with stent implantation.The coagulation indicators[D-dimer(D-D),tissue plasminogen activator(t-PA),prothrombin time(PT)],venous obstruction(obstruction score,thrombolysis rate,venous patency rate)and edema(circumference difference of affected limb,detumescence rate)and hospitalization during treatment(hospital stay,hospitalization cost)and prognosis[secondary lower extremity deep venous valve insufficiency,post-thrombotic syndrome(PTS)]were observed and compared between the two groups of patients.Result:After 5 d of treatment,the D-D level in the surgical group was lower than that in the non-surgical group,the t-PA level was higher than that in the non-surgical group group,and the PT was longer than that in the non-surgical group group(P<0.05).After 3 months of treatment,the obstruction score of the surgical group was lower than that of the non-surgical group(P<0.05);the thrombolysis rate and venous patency rate in surgical group were higher than those in non-surgical group(P<0.05).After 3 months of treatment,circumference differences of upper knee and lower knee of affected limb in the surgical group were smaller than those in the non-surgical group(P<0.05);the swelling reduction rate above and below the knee in surgical group were higher than those in non-surgical group(P<0.05).The number of days in hospital in surgical group was less than that in non-surgical group(P<0.05).The incidence of secondary deep venous valvular insufficiency and PTS in surgical group were lower than those in non-surgical group(P<0.05).Conclusion:CDT combined with stent implantation can improve the clinical symptoms of IVCS patients with lower extremity DVT,and the therapeutic effect is better than that of conventional systemic thrombolysis therapy,and the recovery after treatment is faster and the prognosis is more ideal.
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