我们分析了我们在使用药物机械导管导向溶栓 (PMCDT) 治疗急性髂股深静脉血栓形成 (IFDVT) 中的单中心即时和随访结果，以确定安全性、准确性和对生活质量的影响，以及这是否治疗策略可预防血栓形成后综合征 (PTS)。

对2017年1月至2018年12月接受PMCDT治疗IFDVT的230例患者进行回顾性分析。研究了术前、术中和术后变量、Marder 评分、结果以及使用 Villalta 评分和静脉临床严重程度评分的随访评估。

230 名患者中有 95.2% 获得了解剖学成功。术后平均 Marder 评分从 12.65 ± 2.1 下降到 2.4 ± 1.3 ( P  < .01)。13 名患者（5.65%）出现早期复发性血栓形成。1 个月、6 个月和 12 个月随访的主要通畅率分别为 94.0%、87.2% 和 81.7%。从 1 到 6 个月，Villalta 评分从 8.32 ± 4.14 下降到 3.43 ± 0.61，静脉临床严重程度评分从 4.0 ± 1.8 下降到 1.82 ± 0.36 ( P  < .05)。随访 12 个月时与 6 个月时相比，PTS 严重程度评分无统计学差异。静脉疾病特异性生活质量从基线到 12 个月的平均变化为 29.41 ± 1.99 ( P = .029)。1年总复发率为19.63%。

对于选定的一组急性 IFDVT 患者，使用 PMCDT 和术后抗凝治疗可显着减少血栓负荷、腿部疼痛和肿胀，从而在 6 个月时显着降低 PTS 严重程度评分。

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Background

We have analyzed our single-center immediate and follow-up results in the management of acute iliofemoral deep vein thrombosis (IFDVT) using pharmacomechanical catheter-directed thrombolysis (PMCDT) to determine the safety, accuracy, and effects on quality of life and whether this treatment strategy prevents post-thrombotic syndrome (PTS).

The cases of 230 patients who had undergone PMCDT to treat IFDVT from January 2017 to December 2018 were retrospectively reviewed. The preoperative, operative, and postoperative variables, Marder scores, outcomes, and follow-up assessments with the Villalta score and venous clinical severity score were investigated.

Anatomic success was achieved for 95.2% of the 230 patients. The mean Marder score had decreased from 12.65 ± 2.1 to 2.4 ± 1.3 postoperatively (P < .01). Early recurrent thrombosis had developed in 13 patients (5.65%). The primary patency at the 1-, 6-, and 12-month follow-up visits was 94.0%, 87.2%, and 81.7%, respectively. From 1 to 6 months, the Villalta score had decreased from 8.32 ± 4.14 to 3.43 ± 0.61 and the venous clinical severity score had decreased from 4.0 ± 1.8 to 1.82 ± 0.36 (P < .05). No statistically significant difference was found in the PTS severity scores at 12 months of follow-up compared with at 6 months. The mean change in the venous disease-specific quality of life from baseline to 12 months was 29.41 ± 1.99 (P = .029). The total recurrence rate was 19.63% at 1 year.

For a select group of patients with acute IFDVT, the use of PMCDT and postoperative anticoagulation therapy offered significant reductions in clot burden, leg pain, and swelling, achieving a significant reduction in PTS severity scores at 6 months.