Abstract:

Objective To investigate the feasibility and clinical efficacy of catheter⁃directed thrombolysis （CDT）for acute mixed lower extremity deep venous thrombosis（DVT）via sub⁃knee vein access. Methods The clinical data of patients with acute mixed DVT treated in our unit from January 2020 to December 2021 were retro⁃ spectively analyzed，and the patients were divided into observation group and control group according to different accesses. CDT via anterior or posterior tibial vein access was performed in the observation group，and in the control group CDT via the popliteal vein access was applied. Perimeter difference of the healthy side and affected side， detumescence rate of the affected limb，venous patency rate，the total amount of urokinase used，the length of hospi⁃ tal stay，and postoperative complications of the two groups were recorded and compared. Results Clinical efficacy in terms of thrombus removal effect（1 case of grade 1，1 case of grade 2，and 27 cases of grade 3），postoperative venous patency rate（86.2 ± 12.4）% and postoperative porter score（1.2 ± 0.9），postoperative calf circumference difference（1.0 ± 0.8）cm，and lower leg swelling rate（70.3 ± 19.0）%，in the observation group was better when compared with those in the control group，showing statistical significance（P < 0.05）. Conclusion Compared with popliteal vein access，CDT via inferior knee vein in the treatment of mixed DVT has obvious advantages in postop⁃ erative clinical efficacy，and the application of the inferior knee vein approach does not increase the incidence of postoperative complications in patients.

Key words:

lower extremity deep vein thrombosis, catheter?contact thrombolysis, posterior tibial vein