Comprehensive treatment for acute iliac femoral vein thrombosis complicating left iliac vein compression

Objective To explore the significance of comprehensive treatment including anticoagulation, inferior vena cava filter implantation, mechanical thrombectomy, iliac vein angioplasty and stent placement and catheter-directed thrombolysis(CDT) in the treatment of acute iliac femoral vein thrombosis on the basis of left iliac vein compression. Methods In this study 61 patients were enrolled at Beijing Luhe Hospital, Capital Medical University between Mar 2013 and Mar 2019 in anticoagulation combined with CDT group and comprehensive treatment group. Short-term venous recanalization rate scores and long-term proximal valvular function of left femoral vein were compared. The survival curve was drawn using kaplan-meier method, and incidence of PTS was compared with the Log rank test. Result The short-term venous recanalization rate scores of the patients in the comprehensive treatment group were higher than scores of the patients in the traditional treatment group(t=9.872, P<0.001). 16 patients developed PTS. The incidence of PTS in the comprehensive treatment group was lower than that in the traditional treatment group(χ2=7.146, P=0.008). Patients in comprehensive treatment group kept a better function of the proximal valvular of left femoral vein than patients in the traditional treatment group(χ2=23.834, P<0.001). Conclusion The comprehensive treatment can effectively reduce the occurrence of long-term PTS in patients with acute iliac femoral vein thrombosis complicated with left iliac vein compression, and Improves the quality of patients′ life. Key words: Venous thrombosis; Angioplasty; Mechanical thrombolysis