Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2024; 12(21): 4590-4600
Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4590
Efficacy of percutaneous mechanical thrombus removal in acute lower extremity deep venous thrombosis
Jun-Qiang Xue, Ping Yin, Jian-Ping He, Hui Wei, Cui-Jie Geng, Yu-Xian Luo
Jun-Qiang Xue, Jian-Ping He, Cui-Jie Geng, Yu-Xian Luo, Department of Vascular Surgery, Shijiazhuang People's Hospital, Shijiazhuang 050011, Hebei Province, China
Ping Yin, Department of Laboratory Medicine, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050011, Hebei Province, China
Hui Wei, Catheter Room, Shijiazhuang People's Hospital, Shijiazhuang 050011, Hebei Province, China
Co-first authors: Jun-Qiang Xue and Ping Yin.
Author contributions: Xue JQ and Yin P designed and wrote the manuscript; He JP, Wei H and Geng CJ analysed the data and plotted the graphs; Luo YX supervised the process; All authors reviewed the manuscript.
Supported by the Health and Wellness Commission of Hebei Province, No. 20160344; and the Health Commission of Shijiazhuang City, Hebei Province, No. 221200763.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Shijiazhuang People's Hospital.
Informed consent statement: The data used in this study did not involve any personal privacy information of the patients. All patient data were obtained, recorded, and managed solely for the purposes of this study without causing any harm to the patients. Therefore, the informed consent requirement was waived by the ethics committee of Shijiazhuang People's Hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data should be obtained by contacting the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Xian Luo, MD, Chief Physician, Department of Vascular Surgery, Shijiazhuang People's Hospital, No. 365 Jianhua South Street, Yuhua District, Shijiazhuang 050011, Hebei Province, China. lyxxueguanwaike@163.com
Received: April 24, 2024
Revised: May 30, 2024
Accepted: June 13, 2024
Published online: July 26, 2024
Processing time: 68 Days and 2.9 Hours
Abstract
BACKGROUND

Acute lower extremity deep venous thrombosis (LEDVT) is a common vascular emergency with significant morbidity risks, including post-thrombotic syndrome (PTS) and pulmonary embolism. Traditional treatments like catheter-directed thrombolysis (CDT) often result in variable success rates and complications.

AIM

To investigate the therapeutic efficacy of percutaneous mechanical thrombus removal in acute LEDVT.

METHODS

A retrospective analysis was performed to examine 58 hospitalised patients with acute LEDVT between August 2019 and August 2022. The patients were categorised into the percutaneous mechanical thrombectomy (PMT) group (n = 24) and CDT group (n = 32). The follow-up, safety and treatment outcomes were compared between the two groups. The main observational indexes were venous patency score, thrombus removal effect, complications, hospitalisation duration and PTS.

RESULTS

The venous patency score was 9.04 ± 1.40 in the PMT group and 8.81 ± 1.60 in the CDT group, and the thrombus clearance rate was 100% in both groups. The complication rate was 8.33% in the PMT group and 34.84% in the CDT group, and the difference was statistically significant (P < 0.05). The average hospitalisation duration was 6.54 ± 2.48 days in the PMT group and 8.14 ± 3.56 days in the CDT group. The incidence of PTS was lower in the PMT group than in the CDT group; however, the difference was not statistically significant (P < 0.05).

CONCLUSION

Compared with CDT, treatment of LEDVT via PMT was associated with a better thrombus clearance rate, clinical therapeutic effect and PTS prevention function, but the difference was not statistically significant. Moreover, PMT was associated with a reduced urokinase dosage, shortened hospitalisation duration and reduced incidence of complications, such as infections and small haemorrhages. These results indicate that PMT has substantial beneficial effects in the treatment of LEDVT.

Keywords: Post-thrombotic syndrome; Catheter-directed thrombolysis; Percutaneous mechanical thrombectomy; Acute lower extremity deep venous thrombosis

Core Tip: This retrospective study compares the efficacy of percutaneous mechanical thrombectomy (PMT) and catheter-directed thrombolysis (CDT) in treating acute lower extremity deep venous thrombosis (LEDVT). Results indicate that PMT achieves a comparable thrombus clearance rate to CDT, with significantly lower complication rates, shorter hospital stays, and potentially reduced incidence of post-thrombotic syndrome. The study suggests that PMT offers a safer, more efficient alternative for LEDVT treatment with a notable reduction in the use of urokinase, highlighting its advantages in clinical outcomes and patient care efficiency. Further research is recommended to validate these findings through prospective studies and to explore long-term treatment effects.