Therapeutic Effect of Catheter Thrombolysis Combined with Inferior Vena Cava Filter Placement in Treatment of Floating Inferior Vena Cava Thrombus_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HOUJie ,  YANGYong , YANGGuo-kai , MAZhen-huan , WANJia , LIGuo-jian , DULing-juan , LUPing , ZHANGCheng-long , WULie-ming

Department of Vascular Surgery, The Fourth Affiliated Hospital of Kunming Medical University, Vascular Surgery Center of Yunnan Province, Abdominal Minimally Invasive Surgical Research Center of Yunnan Province, Kunming 650021, Yunnan Province, China;

Corresponding?author：

YANGYong, Email: doctoryang@126.com

Keywords：

Floating thrombus; Catheter thrombolysis; Inferior vena cava filter

DOI：

10.7507/1007-9424.20150243

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Objective To assess the therapeutic effect of catheter thrombolysis combined with inferior vena cava (IVC) filter placement in treatment of deep venous thrombosis (DVT) complicated with floating IVC thrombus. Methods The clinical data of 16 patients with DVT complicated with floating IVC thrombus from July 2013 to November 2014 in this hospital were collected. These patients were treated with the catheter thrombolysis combined with IVC filter placement, the IVC filter was placed via jugular vein, the catheter thrombolysis was performed by the side of the small saphenous vein, the amount of urokinase was (60-80) ×10⁴ U/d. Results ①The floating IVC thrombi of 13 patients were disappeared following catheter thrombolysis combined with IVC filter placement therapy, a small amount of visible thrombi were adhered on the recycled IVC filter, the lower limb swelling was relieved, the IVC could effectively open.②The IVC filters of 2 patients could not be recycled due to the adhesion of floating IVC thrombus and lumen of IVC resulting in luminal stenosis.③The floating IVC thrombus of 1 patient was disappeared, the IVC filter could not be recy-cled due to a large of thrombi adhered on the IVC filter. The lower limb swelling was slowly relieved. The complications such as severe pulmonary embolism didn't happen in all the patients during treatment and following-up. Conclusion The limited data preliminarily shows that it is an effective and safe method by catheter thrombolysis combined with IVC filter placement in treatment of DVT complicated with floating IVC thrombus.

Citation： HOUJie, YANGYong, YANGGuo-kai, MAZhen-huan, WANJia, LIGuo-jian, DULing-juan, LUPing, ZHANGCheng-long, WULie-ming. Therapeutic Effect of Catheter Thrombolysis Combined with Inferior Vena Cava Filter Placement in Treatment of Floating Inferior Vena Cava Thrombus. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 933-936. doi: 10.7507/1007-9424.20150243 Copy

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2.	蔣鵬, 劉建龍, 賈偉, 等.下肢深靜脈血栓脫落致肺栓塞45例臨床報道.中國普外基礎與臨床雜志, 2012, 19(11):1179-1181.
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6.	Usoh F, Hingorani A, Ascher E, et al. Prospective randomized study comparing the clinical outcomes between inferior vena cava Greenfield and TrapEase filters. J Vasc Surg, 2010, 52(2):394-399.
7.	Ignat, ev IM, Akchurin FR, Zanochkin AV, et al. Surgical and endovascular treatment of floating thromboses in the system of the inferior vena cava. Angiol Sosud Khir, 2009, 15(3):57-62.
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10.	文飛.尿激酶脈沖接觸式溶栓治療下肢深靜脈血栓.中國現代藥物應用, 2015, 3(3):143-144.
11.	安兆峰, 劉清泉, 張義偉.導管溶栓術治療急性下肢深靜脈血栓65例臨床分析.中國實用醫藥, 2015, 5(5):3-5.
12.	田軒, 王盛, 劉建龍, 等.下腔靜脈濾器血栓形成局部置管溶栓與外周靜脈溶栓治療的比較.首都醫科大學學報, 2015, 1(1):53-57.
13.	郝軍生, 袁時芳, 李永平.下腔靜脈濾器置入后肺栓塞一例.中華普通外科雜志, 2014, 29(12):926.
14.	劉新奇, 閆盛, 胡杰, 等. Aegisy型可回收性下腔靜脈濾器的動物實驗研究.中國微創外科雜志, 2014, 14(6):555-559.
15.	閆盛, 劉新奇, 張超, 等. Aegisy濾器置入后28 d回收的安全性及可行性分析.中國藥物與臨床, 2014, 07(7):948-951.
16.	Winkler MA, Majmudar PM, Landwehr KP, et al. Use of noncon-trast computed tomography of the inferior vena cava for real-time imaging guidance for the placement of inferior vena cava filters. Int J Angiol, 2015, 24(1):71-74.
17.	Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease:American College of Chest Physi-cians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest, 2008, 133(6 Suppl):454S-545S.

1. Horlander KT, Mannino DM, Leeper KV. Pulmonary embolism mortality in the United States, 1979-1998:an analysis using multiple-cause mortality data. Arch Intern Med, 2003, 163(14):1711-1717.
2. 蔣鵬, 劉建龍, 賈偉, 等.下肢深靜脈血栓脫落致肺栓塞45例臨床報道.中國普外基礎與臨床雜志, 2012, 19(11):1179-1181.
3. 韓冰, 葛長青, 張宏光, 等.下肢深靜脈血栓形成致肺栓塞發生及其應用腔靜脈濾器預防的臨床研究.中國普外基礎與臨床雜志, 2012, 19(11):1156-1162.
4. 馬志強, 魏松洋, 楊瑞麗, 等.下肢深靜脈血栓形成的治療經驗.中國普外基礎與臨床雜志, 2011, 18(2):202-203.
5. Brodmann M, Gary T, Hafner F, et al. Massive pulmonary embolism caused by internal iliac vein thrombosis with free-floating thrombus formation in the inferior vena cava. Ann Vasc Surg, 2012, 26(3):420. e5-420.e7.
6. Usoh F, Hingorani A, Ascher E, et al. Prospective randomized study comparing the clinical outcomes between inferior vena cava Greenfield and TrapEase filters. J Vasc Surg, 2010, 52(2):394-399.
7. Ignat, ev IM, Akchurin FR, Zanochkin AV, et al. Surgical and endovascular treatment of floating thromboses in the system of the inferior vena cava. Angiol Sosud Khir, 2009, 15(3):57-62.
8. Young T, Tang H, Hughes R. Vena caval filters for the prevention of pulmonary embolism. Cochrane Database Syst Rev, 2010, 2:CD006212.
9. 張智輝, 單臻, 王文見, 等.導管溶栓治療對急性深靜脈血栓形成轉歸的影響.中華醫學雜志, 2013, 93(29):2271-2274.
10. 文飛.尿激酶脈沖接觸式溶栓治療下肢深靜脈血栓.中國現代藥物應用, 2015, 3(3):143-144.
11. 安兆峰, 劉清泉, 張義偉.導管溶栓術治療急性下肢深靜脈血栓65例臨床分析.中國實用醫藥, 2015, 5(5):3-5.
12. 田軒, 王盛, 劉建龍, 等.下腔靜脈濾器血栓形成局部置管溶栓與外周靜脈溶栓治療的比較.首都醫科大學學報, 2015, 1(1):53-57.
13. 郝軍生, 袁時芳, 李永平.下腔靜脈濾器置入后肺栓塞一例.中華普通外科雜志, 2014, 29(12):926.
14. 劉新奇, 閆盛, 胡杰, 等. Aegisy型可回收性下腔靜脈濾器的動物實驗研究.中國微創外科雜志, 2014, 14(6):555-559.
15. 閆盛, 劉新奇, 張超, 等. Aegisy濾器置入后28 d回收的安全性及可行性分析.中國藥物與臨床, 2014, 07(7):948-951.
16. Winkler MA, Majmudar PM, Landwehr KP, et al. Use of noncon-trast computed tomography of the inferior vena cava for real-time imaging guidance for the placement of inferior vena cava filters. Int J Angiol, 2015, 24(1):71-74.
17. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease:American College of Chest Physi-cians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest, 2008, 133(6 Suppl):454S-545S.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Therapeutic Effect of Catheter Thrombolysis Combined with Inferior Vena Cava Filter Placement in Treatment of Floating Inferior Vena Cava Thrombus

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