Catheter Directed Thrombolysis Through Three Different Approaches Combined with Iliac Venous Endovascular Therapy for Acute Deep Venous Thrombosis Complicated with Cockett Syndrome of Lower Extremities_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LUHui-jun , LIUHui , YUANYe , MABing-bing , ZHANGMi , HUYa-li , ZHAOYi

Department of Vascular Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, Jiangsu Province, China;

Corresponding?author：

LUHui-jun, Email: lhj9696@sina.com

Keywords：

Cannulation approach; Catheter directed thrombolysis; Cockett syndrome; Deep venous thrombosis; Endovascular therapy

DOI：

10.7507/1007-9424.20150158

Video：

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Objective To investigate the clinical efficacy of catheter directed thrombolysis (CDT) through three different approaches combined with iliac venous endovascular therapy for acute deep venous thrombosis (DVT) complicated with Cockett syndrome of the lower extremities. Method The clinical data of 87 patients with CDT through three different approaches (small saphenous vein group, popliteal vein group, and posterior tibial vein group) combined with iliac venous endovascular therapy for DVT complicated with Cockett syndrome of the lower extremities were analyzed retrospectively. Results The lower extremity swelling of all the patients were disappeared obviously within 72 h after surgery, there was no death related surgery and pulmonary embolism. The limb edema reduction rates had no significant differences among the small saphenous vein group, popliteal vein group, and posterior tibial vein group﹝(77±13)% versus (82±12)% versus (77±18)%, P > 0.05﹞. The recanalization rates of thrombolysis had no significant differences among the above three groups﹝(86.5±10.6)% versus (92.0±7.7)% versus (87.3±7.8)%, P > 0.05﹞. The time required for the cannulation in the posterior tibial vein group was significantly shorter than that of the small saphenous vein group or popliteal vein group﹝(15.14±3.62) min versus (32.62±9.36) min or (42.79±13.30) min, P < 0.01﹞. All the patients were performed by balloon dilatation and iliac vein stenting. Eighty-seven cases were followed-up for 1-24 months, the primary patency rate of iliac venous was 100%. Conclusions CDT with iliac venous endovascular therapy is an effective method in treatment of acute DVT with Cockett syndrome. CDT through posterior tibial vein is an easier and effective method with less complications and time. This way could be acceptable in basal hospital.

Citation： LUHui-jun, LIUHui, YUANYe, MABing-bing, ZHANGMi, HUYa-li, ZHAOYi. Catheter Directed Thrombolysis Through Three Different Approaches Combined with Iliac Venous Endovascular Therapy for Acute Deep Venous Thrombosis Complicated with Cockett Syndrome of Lower Extremities. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(5): 605-609. doi: 10.7507/1007-9424.20150158 Copy

1.	Comerota AJ, Kamath V. Thrombolysis for iliofemoral deep venous thrombosis. Expert Rev Cardiovasc Ther, 2013, 11(12):1631-1638.
2.	李曉強, 段鵬飛, 錢愛民, 等.介入聯合手術治療急性下肢深靜脈血栓形成.中華普通外科雜志, 2006, 21(9):660-661.
3.	Haig Y, Enden T, Slagsvold CE, et al. Determinants of early and long-term efficacy of catheter-directed thrombolysis in proximal deep vein thrombosis. J Vasc Interv Radiol, 2013, 24(1):17-24.
4.	段鵬飛, 肖璋生, 李曉強.導管溶栓聯合髂靜脈介入治療急性下肢深靜脈血栓形成.中華普通外科雜志, 2012, 27(3):193-196.
5.	Porter JM, Moneta GL. Reporting standards in venous disease:an update. International Consensus Committee on Chronic Venous Disease. J Vasc Surg, 1995, 21(4):635-645.
6.	Meng QY, Li XQ, Jiang K, et al. Stenting of iliac vein obstruction following catheter-directed thrombolysis in lower extremity deep vein thrombosis. Chin Med J, 2013, 126(18):3519-3522.
7.	董典寧, 張十一, 金星, 等.腘靜脈置管溶栓聯合髂靜脈支架治療髂股靜脈血栓.中國實用外科雜志, 2007, 27(3):232-234.
8.	Greenfield LJ, Michna BA. Twelve-year clinical experience with the Greenfield vena caval filter. Surgery, 1988, 104(4):706-712.
9.	Hye RJ, Turner C, Valji K, et al. Is thrombolysis of occluded popliteal and tibial bypass grafts worthwhile? J Vasc Surg, 1994, 20(4):588-596.
10.	楊冬山, 李學鋒, 劉汝海, 等.下肢深靜脈血栓取栓術后復發與Cockett綜合征的關系.中國普通外科雜志, 2007, 16(6):539-541.
11.	顧建平, 樓文勝, 何旭, 等.髂靜脈受壓綜合征及繼發血栓形成的介人治療.中華放射學雜志, 2008, 42(8):821-825.
12.	葉志東, 樊雪強, 王非, 等.腔內治療髂靜脈梗阻合并急性深靜脈血栓的臨床經驗.中國微創外科雜志, 2012, 12(4):344-346.
13.	劉鵬, 王豪夫, 王曰偉.髂靜脈受壓綜合征并下肢深靜脈血栓形成的治療探討.齊魯醫學雜志, 2008, 23(3):262-264.
14.	崔艷峰, 徐浩, 祖茂衡, 等.左髂靜脈受壓綜合征并發下肢深靜脈血栓形成的綜合介入治療.介入放射學雜志, 2010, 19(8):602-606.
15.	張希全, 崔佳佳, 王義平, 等.髂靜脈受壓綜合征并下肢深靜脈血栓形成的綜合性腔內治療.中國普通外科雜志, 2014, 23(6):785-790.
16.	張精勇, 金星, 吳學君, 等.濾器保護下置管溶栓治療下肢深靜脈血栓形成臨床總結.中國實用外科雜志, 2006, 26(10):774-776.
17.	李大林, 陳允惠, 顏京強, 等.急性下肢深靜脈血栓的介入治療.臨床普外科電子雜志, 2013, 1(1):44-46, 43.
18.	李德衛, 趙渝, 時德.髂靜脈受壓綜合征的診治.中國普通外科雜志, 2002, 11(7):435-437.
19.	李長海, 張希全, 朱偉, 等.急性混合型下肢深靜脈血栓綜合介入治療與系統溶栓療效的比較.中國普通外科雜志, 2013, 22(12):1595-1599.
20.	王曰偉, 王豪夫, 戚森, 等.腔靜脈濾器聯合導管接觸性溶栓治療靜脈血栓栓塞癥臨床分析.中國血管外科雜志:電子版, 2013, 5(1):38-40.
21.	趙渝, 李德衛, 時德, 等.髂靜脈受壓綜合征的解剖基礎.中國實用外科雜志, 2003, 23(12):745-746.
22.	趙軍, 董國祥.左髂總靜脈狹窄與急性下肢深靜脈血栓形成.中華外科雜志, 1998, 36(1):12-14.
23.	張希全, 王義平, 朱偉, 等.微創治療髂靜脈閉塞合并下肢深靜脈血栓形成.中國介入影像與治療學, 2012, 9(12):843-846.
24.	張文廣, 李震, 韓新巍, 等.經導管接觸溶栓與單純靜脈藥物溶栓治療下肢深靜脈血栓的對比分析.中國普外基礎與臨床雜志, 2012, 19(11):1171-1174.

1. Comerota AJ, Kamath V. Thrombolysis for iliofemoral deep venous thrombosis. Expert Rev Cardiovasc Ther, 2013, 11(12):1631-1638.
2. 李曉強, 段鵬飛, 錢愛民, 等.介入聯合手術治療急性下肢深靜脈血栓形成.中華普通外科雜志, 2006, 21(9):660-661.
3. Haig Y, Enden T, Slagsvold CE, et al. Determinants of early and long-term efficacy of catheter-directed thrombolysis in proximal deep vein thrombosis. J Vasc Interv Radiol, 2013, 24(1):17-24.
4. 段鵬飛, 肖璋生, 李曉強.導管溶栓聯合髂靜脈介入治療急性下肢深靜脈血栓形成.中華普通外科雜志, 2012, 27(3):193-196.
5. Porter JM, Moneta GL. Reporting standards in venous disease:an update. International Consensus Committee on Chronic Venous Disease. J Vasc Surg, 1995, 21(4):635-645.
6. Meng QY, Li XQ, Jiang K, et al. Stenting of iliac vein obstruction following catheter-directed thrombolysis in lower extremity deep vein thrombosis. Chin Med J, 2013, 126(18):3519-3522.
7. 董典寧, 張十一, 金星, 等.腘靜脈置管溶栓聯合髂靜脈支架治療髂股靜脈血栓.中國實用外科雜志, 2007, 27(3):232-234.
8. Greenfield LJ, Michna BA. Twelve-year clinical experience with the Greenfield vena caval filter. Surgery, 1988, 104(4):706-712.
9. Hye RJ, Turner C, Valji K, et al. Is thrombolysis of occluded popliteal and tibial bypass grafts worthwhile? J Vasc Surg, 1994, 20(4):588-596.
10. 楊冬山, 李學鋒, 劉汝海, 等.下肢深靜脈血栓取栓術后復發與Cockett綜合征的關系.中國普通外科雜志, 2007, 16(6):539-541.
11. 顧建平, 樓文勝, 何旭, 等.髂靜脈受壓綜合征及繼發血栓形成的介人治療.中華放射學雜志, 2008, 42(8):821-825.
12. 葉志東, 樊雪強, 王非, 等.腔內治療髂靜脈梗阻合并急性深靜脈血栓的臨床經驗.中國微創外科雜志, 2012, 12(4):344-346.
13. 劉鵬, 王豪夫, 王曰偉.髂靜脈受壓綜合征并下肢深靜脈血栓形成的治療探討.齊魯醫學雜志, 2008, 23(3):262-264.
14. 崔艷峰, 徐浩, 祖茂衡, 等.左髂靜脈受壓綜合征并發下肢深靜脈血栓形成的綜合介入治療.介入放射學雜志, 2010, 19(8):602-606.
15. 張希全, 崔佳佳, 王義平, 等.髂靜脈受壓綜合征并下肢深靜脈血栓形成的綜合性腔內治療.中國普通外科雜志, 2014, 23(6):785-790.
16. 張精勇, 金星, 吳學君, 等.濾器保護下置管溶栓治療下肢深靜脈血栓形成臨床總結.中國實用外科雜志, 2006, 26(10):774-776.
17. 李大林, 陳允惠, 顏京強, 等.急性下肢深靜脈血栓的介入治療.臨床普外科電子雜志, 2013, 1(1):44-46, 43.
18. 李德衛, 趙渝, 時德.髂靜脈受壓綜合征的診治.中國普通外科雜志, 2002, 11(7):435-437.
19. 李長海, 張希全, 朱偉, 等.急性混合型下肢深靜脈血栓綜合介入治療與系統溶栓療效的比較.中國普通外科雜志, 2013, 22(12):1595-1599.
20. 王曰偉, 王豪夫, 戚森, 等.腔靜脈濾器聯合導管接觸性溶栓治療靜脈血栓栓塞癥臨床分析.中國血管外科雜志:電子版, 2013, 5(1):38-40.
21. 趙渝, 李德衛, 時德, 等.髂靜脈受壓綜合征的解剖基礎.中國實用外科雜志, 2003, 23(12):745-746.
22. 趙軍, 董國祥.左髂總靜脈狹窄與急性下肢深靜脈血栓形成.中華外科雜志, 1998, 36(1):12-14.
23. 張希全, 王義平, 朱偉, 等.微創治療髂靜脈閉塞合并下肢深靜脈血栓形成.中國介入影像與治療學, 2012, 9(12):843-846.
24. 張文廣, 李震, 韓新巍, 等.經導管接觸溶栓與單純靜脈藥物溶栓治療下肢深靜脈血栓的對比分析.中國普外基礎與臨床雜志, 2012, 19(11):1171-1174.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Catheter Directed Thrombolysis Through Three Different Approaches Combined with Iliac Venous Endovascular Therapy for Acute Deep Venous Thrombosis Complicated with Cockett Syndrome of Lower Extremities

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