Preliminary application of Acostream percutaneous aspiration thromboembolectomy sequential low-dose alteplase in the treatment of lower extremity deep vein thrombosis
Journal Title: Chinese Journal of Clinical Research - Year 2025, Vol 38, Issue 2
Abstract
Objectiv To investigate the efficacy and safety of Acostream percutaneous aspiration thromboembolectomy (PAT) sequential low-dose alteplase (rt-PA) in the treatment of lower extremity deep vein thrombosis(LEDVT). Methods: The clinical data of 22 patients with LEDVT admitted to Nanjing First Hospital from June 2022 to March 2024 were retrospectively analyzed. Data on procedure-related parameters, parameters of combined low-dose rt-PA use, hospital stay, thrombus clearance rate, swelling rate of the affected limb, hemoglobin changes at 48 h after operation, and complications were recorded. Results: The thrombus aspiration time was 1.7(1.4,2.7) min. Immediate post-PAT grade Ⅲ thrombus clearance was achieved in 3 cases (13.6%), grade Ⅱ clearance in 18 cases (81.8%), and grade Ⅰ clearance in 1 case (4.5%). Sequential rt-PA thrombolysis had a thrombolytic time of (51.1±14.6)h and a dose of 21.0(20.0,36.5)mg, with grade Ⅲ clearance in 14 cases (63.6%), grade Ⅱ clearance in 7 cases (31.8%), and grade Ⅰ clearance in 1 case (4.5%). The hospital stay was (10.4±3.2)d. After thrombolytic therapy, the reduction in thigh circumference was (1.7±0.8)cm, and the reduction in calf circumference was 0.8 (0.5,1.3)cm. Small bleeding events occurred in 7 patients during hospitalization. No new renal function impairment, allergic reactions, or severe complications were observed. After 6 months of follow-up, thrombosis recurred in 1 patient after the initial treatment, and 1 patient developed mild post-thrombotic syndrome 6 months post-procedure; the mean Villalta score was 2(1,2) for the 22 patients. Conclusion: Acostream mechanical thrombectomy followed by low-dose rt-PA can rapidly reduce thrombus burden and restore limb blood flow, and it is preliminarily assessed as a safe and effective treatment for LEDVT patients.
Authors and Affiliations
JIANG Rui, GONG Maofeng, LIU Zhengli, ZHAO Boxiang,KONG Jie, GU Jianping, HE Xu
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