Annals of vascular surgery · 2025
Early Thrombus Removal Through Peroneal Venous Approach for Treating Acute Iliofemoral Deep Vein Thrombosis.
СтатьяНазвание и аннотация: Перевод в очереди
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Tian Hao, Li Fenghe, Zhao Yu, Teng Biyun, Zeng Qiu
Аннотация
BACKGROUND: The purpose of this study was to evaluate the safety, effectiveness, and feasibility of thrombus removal using the peroneal vein (PeV) approach in acute iliofemoral deep vein thrombosis (IFDVT).
METHODS: From May 2019 to July 2020, the acute IFDVT patients who had undergone AngioJet pharmacomechanical thrombectomy and/or manual aspiration thrombectomy through PeV access were analyzed retrospectively. Clinical characteristics, operative and postoperative therapy details, and PeV access-related data were investigated. Outcome measures included thrombus removal grade, venous patency rate, and the incidence of postthrombotic syndrome (PTS). All patients were followed up for a minimum of 1 year.
RESULTS: A total of 42 patients were reviewed. The thrombus involved the popliteal vein in 85.7% (n = 36) of cases. The PeV access was successfully achieved in all patients through 4 puncture methods. Therein, blind puncture under fluoroscopy was used in 52.4% of patients. Postoperatively, the mean thrombolysis time was 4.8 ± 1.9 days, and the average dose of urokinase was 2.7 ± 1.0 million units. All the patients had successfully thrombus lysis, including 9.5% of grade II lysis and 90.5% of grade III lysis. Three complications occurred during the thrombolysis treatment, including 2 puncture site minor bleeding and 1 minor gingival bleeding. During the 1-year follow-up, the venous patency rate and the PTS incidence rate were 97.6% and 9.5%, respectively.
CONCLUSION: Thrombus removal of acute IFDVT through PeV access is safe, effective, and feasible, while large cohort studies are needed to confirm the superiority of PeV access.
METHODS: From May 2019 to July 2020, the acute IFDVT patients who had undergone AngioJet pharmacomechanical thrombectomy and/or manual aspiration thrombectomy through PeV access were analyzed retrospectively. Clinical characteristics, operative and postoperative therapy details, and PeV access-related data were investigated. Outcome measures included thrombus removal grade, venous patency rate, and the incidence of postthrombotic syndrome (PTS). All patients were followed up for a minimum of 1 year.
RESULTS: A total of 42 patients were reviewed. The thrombus involved the popliteal vein in 85.7% (n = 36) of cases. The PeV access was successfully achieved in all patients through 4 puncture methods. Therein, blind puncture under fluoroscopy was used in 52.4% of patients. Postoperatively, the mean thrombolysis time was 4.8 ± 1.9 days, and the average dose of urokinase was 2.7 ± 1.0 million units. All the patients had successfully thrombus lysis, including 9.5% of grade II lysis and 90.5% of grade III lysis. Three complications occurred during the thrombolysis treatment, including 2 puncture site minor bleeding and 1 minor gingival bleeding. During the 1-year follow-up, the venous patency rate and the PTS incidence rate were 97.6% and 9.5%, respectively.
CONCLUSION: Thrombus removal of acute IFDVT through PeV access is safe, effective, and feasible, while large cohort studies are needed to confirm the superiority of PeV access.