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. 2016 Aug 23:22:2972-80.
doi: 10.12659/msm.897016.

Catheter-Directed Thrombolysis via Small Saphenous Veins for Treating Acute Deep Venous Thrombosis

Bin Yang  1 , Xiao-Dong Xu  2 , Peng Gao  1 , Ji-Xiang Yu  1 , Yu Li  1 , Ai-Dong Zhu  1 , Ran-Ran Meng  1
Affiliations

Catheter-Directed Thrombolysis via Small Saphenous Veins for Treating Acute Deep Venous Thrombosis

Bin Yang et al. Med Sci Monit. .

Abstract

BACKGROUND There is little data comparing catheter-directed thrombolysis (CDT) via small saphenous veins vs. systematic thrombolysis on complications and efficacy in acute deep venous thrombosis patients. The aim of our study was to compare the efficacy and safety of CDT via the small saphenous veins with systematic thrombolysis for patients with acute deep venous thrombosis (DVT). MATERIAL AND METHODS Sixty-six patients with acute DVT admitted from June 2012 to December 2013 were divided into 2 groups: 27 patients received systemic thrombolysis (ST group) and 39 patients received CDT via the small saphenous veins (CDT group). The thrombolysis efficiency, limb circumference differences, and complications such as post-thrombotic syndrome (PTS) in the 2 groups were recorded. RESULTS The angiograms demonstrated that all or part of the fresh thrombus was dissolved. There was a significant difference regarding thrombolysis efficiency between the CDT group and ST group (71.26% vs. 48.26%, P=0.001). In both groups the postoperative limb circumference changes were higher compared to the preoperative values. The differences between postoperative limb circumferences on postoperative days 7 and 14 were significantly higher in the CDT group than in the ST group (all P<0.05). The incidence of postoperative PTS in the CDT group (17.9%) was significantly lower in comparison to the ST group (51.85%) during the follow-up (P=0.007). CONCLUSIONS Catheter-directed thrombolysis via the small saphenous veins is an effective, safe, and feasible approach for treating acute deep venous thrombosis.

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Figures

Figure 1
Figure 1
A small incision of about 1–2 cm was made longitudinally midway between the external malleolus and the Achilles tendon of affected limbs.
Figure 2
Figure 2
The guide wire and catheter were entered into the popliteal vein.
Figure 3
Figure 3
Venography shows a large amount of thrombogenesis in the femoropoplitea vein before thrombolysis.
Figure 4
Figure 4
Venography shows a large amount of thrombogenesis in the femoral vein before thrombolysis.
Figure 5
Figure 5
Venography shows femoral and popliteal vein thrombolysis and vessel patency 3 days after CDT via the small saphenous veins.
Figure 6
Figure 6
Venography shows femoral vein thrombolysis and vessel patency 4 days after thrombolysis CDT via the small saphenous veins.
See this image and copyright information in PMC

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