Post-thrombotic syndrome after catheter thrombolysis combined with stent implantation for acute deep venous thrombosis of the lower extremity with iliac vein lesion
Zhang Xiaotao1, Gao Yong2, Lu Ran2, Wu Zifu2
1Department of Vascular Surgery, Lixin County People's Hospital, Bozhou 236700, China; 2Department of Vascular Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
Abstract：Objective This study aimed to investigate the incidence of post-thrombotic syndrome (PTS) in patients with acute deep venous thrombosis of the lower extremity with iliac vein lesions treated by catheter-directed thrombolysis combined with stent implantation. Methods A cross-sectional study was conducted. Clinical data of 61 patients with acute deep venous thrombosis of the lower extremities with iliac vein lesions treated by transcatheter thrombolysis combined with stent in Lixin People's Hospital and the First Affiliated Hospital of Bengbu Medical College were included in this study. Of the 61 patients, 20 were males and 41 were females, aged 24-75 (55.7±11.7) years, including four cases with hypertension and five cases with diabetes mellitus. The incidence and severity of PTS were assessed by using the Venous Clinical Severity Score (VCSS) and Villalta scale at 6, 12, and 24 months after operation, and the incidence of restenosis of iliac vein stent was re-examined simultaneously. Results The operation was successfully performed in all patients, and 68 stents were implanted in 61 patients. All patients were followed up for more than 2 years (24.5-30.2 months). No postoperative death, pulmonary embolism, severe bleeding, and other adverse events occurred during follow-up for 24 months. During discharge follow-up, six patients had minor bleeding, and 16 patients had PTS. The Villalta score showed that the incidence of PTS was 6.56% (4/61, four mild cases), 14.75% (9/61, eight mild cases and one moderate case), and 26.23% (16/61, 14 mild cases and two moderate cases), and the VCSS was 3.64±1.21, 4.62±1.36, and 5.62±1.75, respectively. VCSS and PTS were significantly different at 6, 12, and 24 months (F=66.36, χ2=18.17, respectively; all P values <0.001). The iliac vein stenosis occurred in two patients with moderate PTS, and the patency rate of iliac vein stent was 96.72% (59/61) within 2 years. Conclusion Catheter thrombolysis combined with stent therapy for acute deep venous thrombosis of the lower extremities in patients with iliac vein disease has a low incidence of PTS in the near and medium term within 2 years. However, the severity has progressed with the extension of observation time, which requires continuous attention.
张小涛, 高涌, 卢冉, 武子赋. 导管溶栓联合支架治疗髂静脉病变型急性下肢深静脉血栓形成术后血栓后综合征的观察[J]. 中华解剖与临床杂志, 2023, 28(6): 395-399.
Zhang Xiaotao, Gao Yong, Lu Ran, Wu Zifu. Post-thrombotic syndrome after catheter thrombolysis combined with stent implantation for acute deep venous thrombosis of the lower extremity with iliac vein lesion. Chinese Journal of Anatomy and Clinics, 2023, 28(6): 395-399.
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2023, Vol. 28 
