Calf Deep Veins Are Safe And Feasible Accesses For The Endovascular Treatment Of Acute Lower Extremity Deep Vein Thrombosis

Author:

Zeng Xiande1,Chen Wei1,Min Xixi1,Zhou Weimin1,Qiu Jiehua1

Affiliation:

1. Second Affiliated Hospital of Nanchang University

Abstract

Abstract Purpose This study was designed to assess the optimal access route for the endovascular treatment of acute lower extremity deep vein thrombosis. Methods This was a retrospective analysis of patients with acute lower extremity deep venous thrombosis who underwent endovascular treatment from February 2009 – December 2020. Patients underwent non-direct calf deep vein puncture (NDCDVP) from February 2009 - December 2011 and direct calf deep vein group (DCDVP) from January 2012 - December 2020. Catheter directed thrombolysis (CDT) was used to treat all patients in the NDCDVP group, whereas patients in the DCDVP group were treated with CDT or the AngioJet rheolytic thrombectomy system. In patients exhibiting iliac vein compression syndrome, the iliac vein was dilated and implanted with a stent. Technical success rates and perioperative complication rates were compared between these two treatment groups. Results The NDCDVP group included 83 patients (40 males, 43 females) with a mean age of 55 ± 16 years, while the DCDVP group included 487 patients (231 males. 256 females) with a mean age of 56 ± 15 years. No significant differences were observed between these groups with respect to any analyzed clinical characteristics. The technical success rates in the NDCDVP and DCDVP groups were 96.4% and 98.2%, respectively (P > 0.05). In the NDCDVP group, the sall saphenous vein(SSV)or great saphenous vein༈GSV༉were the most common access routes (77.1%, 64/83), whereas the anterior tibial vein was the most common access route in the DCDVP group (78.0%, 380/487), followed by the posterior tibial vein and peroneal vein (15.6% and 6.4%, respectively). Relative to the NDCDVP group, more patients in the DCDVP group underwent the removal of deep vein clots below the knee (7.2% [6/83] vs. 24.2% [118/487], P < 0.001). Moreover, relative to the NDCDVP group, significantly lower complication rates were evident in the DCDVP group (local infection: 10.8% vs. 0.4%, P < 0.001; local hematoma: 15.7% vs. 1.0%, P < 0.001). The position change rate was also significantly lower in the DCDVP group relative to the NDCDVP group (0% [0/487] vs. 60.2% [50/83], P < 0.001). Conclusion The calf deep veins represent a feasible and safe access route for the endovascular treatment of lower extremity deep vein thrombosis.

Publisher

Research Square Platform LLC

Reference31 articles.

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4. Kahn, S. R. et al. Article Annals of Internal Medicine Determinants and Time Course of the Postthrombotic Syndrome after Acute Deep Venous Thrombosis. (2017).

5. Comparison of Direct Iliofemoral Stenting Following AngioJet Rheolytic Thrombectomy vs Staged Stenting After AngioJet Rheolytic Thrombectomy Plus Catheter-Directed Thrombolysis in Patients With Acute Deep Vein Thrombosis;Shi H,2017

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