The Journal of Practical Medicine >

2023 , Vol. 39 >Issue 18: 2362 - 2367

DOI: https://doi.org/10.3969/j.issn.1006-5725.2023.18.013

Clinical Research

Evaluation value of monitoring changes of ultrasonic elastic imaging parameters before and after CDT combined with ART in patients with acute deep venous thrombosis of lower extremities

  • Jianghao PAN ,
  • Jianming SUN ,
  • Jiaming SONG ,
  • Guangyin FU ,
  • Yong LEI ,
  • Xiaojie. ZHANG
Expand
  • Hengshui People's Hospital，Hengshui 053000，China

Received date: 2023-05-10

  Online published: 2023-10-10

Fold

Abstract

Objective To analyze the value of monitoring changes in ultrasound elastography parameters before and after treatment with catheter contact thrombolysis （CDT） combined with AngioJet mechanical thrombus aspiration （ART） in patients with acute lower extremity deep vein thrombosis （DVT） for the assessment of efficacy. Methods One hundred patients with DVT admitted to Hengshui people′s hospital from August 2021 to August 2022 were selected， and all patients received CDT combined with ART and postoperative medication for 10 d. Patients were observed for swelling of the affected limb before and after 10 d of treatment， ultrasound elastography parameters. Patients were divided into ineffective group and effective group according to different curative effects， and baseline data and ultrasonic elastography parameters before treatment were compared between the two groups； the subject operating curve （ROC） was plotted， and the area under the curve （AUC） values were calculated to test the predictive value of ultrasound elastography parameters for treatment ineffectiveness in DVT patients； Spearman's analysis of ultrasound elastography parameters and treatment ineffectiveness in DVT patients was performed using a bivariate correlation variable The correlation between ultrasound elastography parameters and treatment ineffectiveness in DVT patients was analyzed using the bicorrelation variable Spearman. Results After 100 patients with DVT were treated with CDT combined with ART， 34（34.00%） were effective， 53（53.00%） were effective， and 13（13.00%） were ineffective； After treatment， the circumference difference of the affected side thigh and the circumference difference of the affected side calf of DVT patients were smaller than before treatment， and the ultrasonic elastography score， strain value and Young's modulus value were lower than before treatment （P < 0.05）. The ultrasonic elastography score， strain value and Young's modulus in the ineffective group were higher than those in the effective group before treatment （P < 0.05）. The ROC curve shows that the ultrasonic elastography score， strain value， Young's modulus level and combined detection have certain predictive value in predicting the clinical efficacy of DVT patients （AUC = 0.803， 0.793， 0.771）， and the combined detection is the highest （AUC = 0.946）. Among them， the combined test was the highest； using Spearman analysis of dual correlation variables， the results showed that ultrasound elastography score， strain value， and Young's modulus value were positively correlated with treatment ineffectiveness in patients with DVT （r > 0， P<0.05）. Conclusion Ultrasound elastography parameters can effectively predict clinical outcomes after CDT combined with ART in DVT patients， and changes in ultrasound elastography parameters were positively correlated with treatment ineffectiveness.

Key words： acute lower extremity deep vein thrombosis; catheter-contact thrombolysis; angioJet mechanical thrombus aspiration; ultrasound elastography parameters; clinical efficacy

Cite this article

Jianghao PAN , Jianming SUN , Jiaming SONG , Guangyin FU , Yong LEI , Xiaojie. ZHANG . Evaluation value of monitoring changes of ultrasonic elastic imaging parameters before and after CDT combined with ART in patients with acute deep venous thrombosis of lower extremities[J]. The Journal of Practical Medicine, 2023 , 39(18) : 2362 -2367 . DOI: 10.3969/j.issn.1006-5725.2023.18.013

References

1 SEGERS P， HENDRIKS B M F， HEUTS S， et al. Deep Venous Thrombosis With Symptomatic Bilateral Pulmonary Embolism After Using an Infrapatellar Strap for Patellofemoral Pain in an Athletic Cardiothoracic Surgeon［J］. Clin J Sport Med， 2021， 31（6）： e509-e511.
2 VEDANTHAM S， SALTER A， LANCIA S， et al. Clinical Outcomes of a Pharmacomechanical Catheter-Directed Venous Thrombolysis Strategy that Included Rheolytic Thrombectomy in a Multicenter Randomized Trial［J］. J Vasc Interv Radiol， 2021， 32（9）： 1296-1309.e7.
3 XU Y， WANG X， SHANG D， et al. Outcome of AngioJet mechanical thrombus aspiration in the treatment of acute lower extremities deep venous thrombosis［J］. Vascular， 2021， 29（3）： 415-423.
4 MATSUOKA A， KOAMI H， SHINADA K， et al. Investigation of differences in coagulation characteristics between hospitalized patients with SARS-CoV-2 Alpha， Delta， and Omicron variant infection using rotational thromboelastometry （ROTEM）： A single-center， retrospective， observational study［J］. J Clin Lab Anal， 2022， 36（12）： e24796.
5 VASCULAR SURGERY GROUP， SURGICAL BRANCH OF CHINESE MEDICAL ASSOCIATION. Guidelines for the diagnosis and treatment of deep vein thrombosis （third edition） ［J］. Chin J Vasc Surg， 2017， 9（4） ： 201-208.
6 TU L K， NIE M L， FU J， et al. Comparing the efficacy of endovascular treatment for iliac vein compression syndrome with or without acute deep venous thrombosis： A single-center retrospective study［J］. Vascular， 2022， 30（2）： 341-348.
7 ELKHOULY A， ENOS D， FOX J. Retraction： Ultrasound-Facilitated Catheter-Directed Thrombolysis via Dual Right Upper Extremity Venous Access Into the Basilic Vein in a Case of Submassive Pulmonary Embolism［J］. Cureus， 2021， 13（3）： r23.
8 ZHENG X， XUE M， ZHOU Y， et al. Effectiveness of pigtail catheter crushing combined with AngioJet mechanical aspiration for treatment of acute left iliofemoral vein thrombosis［J］. Asian J Surg， 2022， 45（1）： 226-231.
9 POUNCEY A L， GWOZDZ A M， JOHNSON O W， et al. AngioJet Pharmacomechanical Thrombectomy and Catheter Directed Thrombolysis vs. Catheter Directed Thrombolysis Alone for the Treatment of Iliofemoral Deep Vein Thrombosis： A Single Centre Retrospective Cohort Study［J］. Eur J Vasc Endovasc Surg， 2020， 60（4）： 578-585.
10 PARAMALINGAM S， MORGAN K， BECCE F， et al. Conventional ultrasound and elastography as imaging outcome tools in autoimmune myositis： A systematic review by the OMERACT ultrasound group［J］. Semin Arthritis Rheum， 2021， 51（3）： 661-676.
11 FANG S， CHANG L， CHEN F， et al. Endobronchial Ultrasound Elastography Combined With Computed Tomography in Differentiating Benign from Malignant Intrathoracic Lymph Nodes［J］. Surg Innov， 2021， 28（5）： 590-599.
12 SIVAKUMARAN L， ALTURKISTANI H， LEROUGE S， et al. Strain Ultrasound Elastography of Aneurysm Sac Content after Randomized Endoleak Embolization with Sclerosing vs. Non-sclerosing Chitosan-based Hydrogels in a Canine Model［J］. J Vasc Interv Radiol， 2022， 33（5）： 495-504.
13 NOTTEN P， DE SMET AAEA， TICK L W， et al. CAVA （Ultrasound-Accelerated Catheter-Directed Thrombolysis on Preventing Post-Thrombotic Syndrome） Trial： Long-Term Follow-Up Results［J］. J Am Heart Assoc， 2021， 10（11）： e018973.
14 FARROKHI M， KHURSHID M， MOHAMMADI S， et al. Comparison of ultrasound-accelerated versus conventional catheter-directed thrombolysis for deep vein thrombosis： A systematic review and meta-analysis［J］. Vascular， 2022， 30（2）： 365-374.
15 LEE J K， KIM K Y， BYUN S J， et al. Safety and Efficacy of Aspiration Thrombectomy or Pharmacomechanical Thrombectomy after Catheter-Directed Thrombolysis for the Treatment of Acute Iliofemoral Deep Vein Thrombosis［J］. Vasc Specialist Int， 2020， 36（3）： 144-150.
16 SIVAKUMARAN L， ALTURKISTANI H， LEROUGE S， et al. Strain Ultrasound Elastography of Aneurysm Sac Content after Randomized Endoleak Embolization with Sclerosing vs. Non-sclerosing Chitosan-based Hydrogels in a Canine Model［J］. J Vasc Interv Radiol， 2022， 33（5）： 495-504.
17 ZHANG R， LUO S， HAO L K， et al. Preparation and Properties of Thrombus-Targeted Urokinase/Multi-Walled Carbon Nanotubes （MWCNTs）-Chitosan （CS）-RGD Drug Delivery System［J］. J Biomed Nanotechnol， 2021， 17（9）： 1711-1725.
18 NAN D， JIN H， YANG D， et al. Combination of Polyethylene Glycol-Conjugated Urokinase Nanogels and Urokinase for Acute Ischemic Stroke Therapeutic Implications［J］. Transl Stroke Res， 2021， 12（5）： 844-857.
19 ZHANG D B， ZHANG K W， LU D H， et al. ［Analysis of the short-and medium-term curative effect of TIPS approach combined with AngioJet thrombus aspiration technology treatment in acute portal vein thrombosis］［J］. Zhonghua Gan Zang Bing Za Zhi， 2021， 29（8）： 754-758.
20 LAKHA S， QIAN L， LIPSON S， et al. Severe Intraoperative Hypertension Associated With AngioJet Rheolytic Thrombectomy for Lower Extremity Deep Venous Thrombosis［J］. J Cardiothorac Vasc Anesth， 2021， 35（4）： 1254-1255.
21 BOSIO G， ZENATI N， DESTREMPES F， et al. Shear Wave Elastography and Quantitative Ultrasound as Biomarkers to Characterize Deep Vein Thrombosis In Vivo［J］. J Ultrasound Med， 2022， 41（7）： 1807-1816.
22 LI X， XIE H， ZHANG Y， et al. Individual Choice for the Aspiration Thrombectomy Treatment of Acute Iliofemoral Deep Venous Thrombosis［J］. Ann Vasc Surg， 2020， 69（7）： 237-245.
Options
Outlines

/

〈 〉