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

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.	蒋鹏, 刘建龙, 贾伟, 等.下肢深静脉血栓脱落致肺栓塞45例临床报道.中国普外基础与临床杂志, 2012, 19(11):1179-1181.
3.	韩冰, 葛长青, 张宏光, 等.下肢深静脉血栓形成致肺栓塞发生及其应用腔静脉滤器预防的临床研究.中国普外基础与临床杂志, 2012, 19(11):1156-1162.
4.	马志强, 魏松洋, 杨瑞丽, 等.下肢深静脉血栓形成的治疗经验.中国普外基础与临床杂志, 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.	张智辉, 单臻, 王文见, 等.导管溶栓治疗对急性深静脉血栓形成转归的影响.中华医学杂志, 2013, 93(29):2271-2274.
10.	文飞.尿激酶脉冲接触式溶栓治疗下肢深静脉血栓.中国现代药物应用, 2015, 3(3):143-144.
11.	安兆峰, 刘清泉, 张义伟.导管溶栓术治疗急性下肢深静脉血栓65例临床分析.中国实用医药, 2015, 5(5):3-5.
12.	田轩, 王盛, 刘建龙, 等.下腔静脉滤器血栓形成局部置管溶栓与外周静脉溶栓治疗的比较.首都医科大学学报, 2015, 1(1):53-57.
13.	郝军生, 袁时芳, 李永平.下腔静脉滤器置入后肺栓塞一例.中华普通外科杂志, 2014, 29(12):926.
14.	刘新奇, 闫盛, 胡杰, 等. Aegisy型可回收性下腔静脉滤器的动物实验研究.中国微创外科杂志, 2014, 14(6):555-559.
15.	闫盛, 刘新奇, 张超, 等. Aegisy滤器置入后28 d回收的安全性及可行性分析.中国药物与临床, 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. 蒋鹏, 刘建龙, 贾伟, 等.下肢深静脉血栓脱落致肺栓塞45例临床报道.中国普外基础与临床杂志, 2012, 19(11):1179-1181.
3. 韩冰, 葛长青, 张宏光, 等.下肢深静脉血栓形成致肺栓塞发生及其应用腔静脉滤器预防的临床研究.中国普外基础与临床杂志, 2012, 19(11):1156-1162.
4. 马志强, 魏松洋, 杨瑞丽, 等.下肢深静脉血栓形成的治疗经验.中国普外基础与临床杂志, 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. 张智辉, 单臻, 王文见, 等.导管溶栓治疗对急性深静脉血栓形成转归的影响.中华医学杂志, 2013, 93(29):2271-2274.
10. 文飞.尿激酶脉冲接触式溶栓治疗下肢深静脉血栓.中国现代药物应用, 2015, 3(3):143-144.
11. 安兆峰, 刘清泉, 张义伟.导管溶栓术治疗急性下肢深静脉血栓65例临床分析.中国实用医药, 2015, 5(5):3-5.
12. 田轩, 王盛, 刘建龙, 等.下腔静脉滤器血栓形成局部置管溶栓与外周静脉溶栓治疗的比较.首都医科大学学报, 2015, 1(1):53-57.
13. 郝军生, 袁时芳, 李永平.下腔静脉滤器置入后肺栓塞一例.中华普通外科杂志, 2014, 29(12):926.
14. 刘新奇, 闫盛, 胡杰, 等. Aegisy型可回收性下腔静脉滤器的动物实验研究.中国微创外科杂志, 2014, 14(6):555-559.
15. 闫盛, 刘新奇, 张超, 等. Aegisy滤器置入后28 d回收的安全性及可行性分析.中国药物与临床, 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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