AngioJet机械血栓清除术在急性下肢深静脉血栓形成并Cockett综合征中的应用OA

Objective:Catheter-directed thrombolysis(CDT)is the traditional treatment for acute lower extremity deep venous thrombosis(DVT),but it has limitations such as prolonged thrombolysis time and a risk of bleeding.In recent years,percutaneous mechanical thrombectomy(PMT)has gradually been applied in clinical practice.This study aims to evaluate the efficacy and safety of AngioJet PMT in patients with DVT complicated by Cockett syndrome. Methods:Clinical data of 27 patients with acute lower limb DVT combined with Cockett syndrome who received AngioJet PMT at the Second Xiangya Hospital of Central South University from March 2021 to October 2023 were retrospectively analyzed.All patients were treated under the protection of a vena cava filter.AngioJet thrombectomy was combined with iliac vein balloon dilatation or stent implantation,with adjunctive intraoperative catheter aspiration and/or CDT.Postoperatively,anticoagulation therapy was administered.Follow-up was conducted at 1,3,6,12,and 24 months after the procedure.Color Doppler ultrasound of the lower extremity veins or venography was used to evaluate the patency of deep veins and iliac veins of the lower limbs. Results:Interventional treatment was successfully performed in all 27 patients,with a technical success rate of 100%.The AngioJet aspiration time was 430.00(320.00,480.00)s,and the dosage of urokinase during hospitalization was(874 100±675 200)U.Grade Ⅲ thrombus removal was achieved in 13 cases(48.15%),and Grade Ⅱ thrombus removal in 14 cases(51.85%).Three patients underwent simultaneous iliac vein stent implantation.The average hospital stay was 8.00(7.00,10.00)days.The circumferences of the affected limb at 15 cm above the knee and 13 cm below the knee after the procedure were significantly improved compared with that before the procedure,and the differences were statistically significant(all P<0.01).During follow-up,all patients(including the 3 with iliac vein stents)maintained patent deep venous blood flow in the left lower limb.Two patients developed mild post-thrombotic syndrome at the 12-month follow-up,and their symptoms were significantly relieved after conservative treatment. Conclusion:AngioJet mechanical thrombectomy combined with iliac vein interventional therapy is a safe and effective method for the treatment of acute lower extremity DVT complicated by Cockett syndrome.