Guang Liu1,2,3, Xaiobing Liu1,2,3, Ruihua Wang1,2,3, Kaichuang Ye1,2,3, Minyi Yin1,2,3, Xintian Huang1,2,3, Min Lu1,2,3, Weimin Li1,2,3, Xinwu Lu1,2,3, Mier Jiang1,2,3. 1. Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China. 2. The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China. 3. Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Abstract
PURPOSE: To evaluate the safety and efficacy of below the knee (BTK) approach in the treatment of entire limb deep vein thrombosis (DVT). MATERIALS AND METHODS: Retrospective analysis of consecutive CDT treatment of acute entire limb DVT using a BTK approach (September 2010-February 2016) was performed. The patients included 51 men and 28 women with a mean age of 54 years. RESULTS: CDT was performed by accessing the ipsilateral the small saphenous vein (SSV) and posterior tibial vein (PTV; 24 via incision and 64 via puncture). Thirty-four patients underwent CDT within 3 days of symptom onset and lysis was successful in all cases (i.e., grade III).In contrast, only 22 (68.6%, 22/32) of those treated within 4-10 days and 0 (0%) of those treated after 10 days achieved grade III lysis. A total of 16 bleeding complications occurred, none of which were classified as major, and 11 of which were related to numbness at the site of incision. Poor wound healing was observed in one patient. Three patients treated using an SSV approach exhibited partial occlusion. One patient treated using a PTV approach experienced occlusion. During the 24-month follow-up period, the patency and PTS rates were 80.4% (37/46) and 30.4% (14/46), respectively. The overall patency rate was 87.1% (54/62) during a mean follow-up duration of 3.5 years. CONCLUSIONS: The use of a BTK approach in entire-limb DVT via SSV and PTV puncture is feasible and safe and may be considered an alternative to traditional CDT approach.
PURPOSE: To evaluate the safety and efficacy of below the knee (BTK) approach in the treatment of entire limb deep vein thrombosis (DVT). MATERIALS AND METHODS: Retrospective analysis of consecutive CDT treatment of acute entire limb DVT using a BTK approach (September 2010-February 2016) was performed. The patients included 51 men and 28 women with a mean age of 54 years. RESULTS:CDT was performed by accessing the ipsilateral the small saphenous vein (SSV) and posterior tibial vein (PTV; 24 via incision and 64 via puncture). Thirty-four patients underwent CDT within 3 days of symptom onset and lysis was successful in all cases (i.e., grade III).In contrast, only 22 (68.6%, 22/32) of those treated within 4-10 days and 0 (0%) of those treated after 10 days achieved grade III lysis. A total of 16 bleeding complications occurred, none of which were classified as major, and 11 of which were related to numbness at the site of incision. Poor wound healing was observed in one patient. Three patients treated using an SSV approach exhibited partial occlusion. One patient treated using a PTV approach experienced occlusion. During the 24-month follow-up period, the patency and PTS rates were 80.4% (37/46) and 30.4% (14/46), respectively. The overall patency rate was 87.1% (54/62) during a mean follow-up duration of 3.5 years. CONCLUSIONS: The use of a BTK approach in entire-limb DVT via SSV and PTV puncture is feasible and safe and may be considered an alternative to traditional CDT approach.