Clinical value of profunda femoral vein thrombosis clearance in endovascular treatment of acute lower extremity deep vein thrombosis

doi:10.16139/j.1007-9610.2025.01.11

Abstract

Abstract:

Objective To evaluate the safety and efficacy of profunda femoral vein thrombosis clearance in endovascular treatment of acute lower extremity deep venous thrombosis (DVT). Methods From January 2022 to September 2023, clinical data of acute lower extremity DVT patients who underwent percutaneous mechanical thrombectomy (PMT) for profunda femoral vein thrombosis were retrospectively analyzed. The 12-month primary patency rate of iliofemoral vein and incidence of post-thrombotic syndrome(PTS) were analyzed. Results Twenty-two patients were included in the study, and all patients underwent PMT for profunda femoral vein thrombosis. Five patients were treated through the contralateral common femoral vein via crossover approach, and 17 patients were treated through the contralateral common femoral vein combined with the ipsilateral deep vein approach. The 12-month primary patency rate of iliofemoral vein was 90.9% (20/22), and the incidence of PTS was 9.1% (2/22). Conclusions For patients with acute lower extremity DVT undergoing endovascular treatment, PMT for profunda femoral vein thrombosis is safe and effective, achieving good primary patency of iliofemoral vein and low incidence of PTS.

Key words: Profunda femoral vein, Acute lower extremity deep vein thrombosis (DVT), Percutaneous mechanical thrombectomy(PMT), Patency, Post-thrombotic syndrome(PTS)

CLC Number:

R543.6

NI Qihong, CHEN Jiaquan, GUO Xiangjiang, YE Meng, ZHANG Lan. Clinical value of profunda femoral vein thrombosis clearance in endovascular treatment of acute lower extremity deep vein thrombosis[J]. Journal of Surgery Concepts & Practice, 2025, 30(01): 61-65.

Figures/Tables 2

References 16

[1]	KHAN F, TRITSCHLER T, KAHN S R, et al. Venous thromboembolism[J]. Lancet, 2021, 398(10294):64-77. doi: 10.1016/S0140-6736(20)32658-1 pmid: 33984268
[2]	DUFFETT L. Deep venous thrombosis[J]. Ann Intern Med, 2022, 175(9):ITC129-ITC144.
[3]	STEVENS S M, WOLLER S C, BAUMANN KREUZIGER L, et al. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report[J]. Chest, 2021, 160(6):2247-2259.
[4]	MAZZOLAI L, AGENO W, ALATRI A, et al. Second consensus document on diagnosis and management of acute deep vein thrombosis: updated document elaborated by the ESC Working Group on aorta and peripheral vascular diseases and the ESC Working Group on pulmonary circulation and right ventricular function[J]. Eur J Prev Cardiol, 2022, 29(8):1248-1263.
[5]	中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第三版)[J]. 中华普通外科杂志, 2017, 9(4):250-257.
	Vascular Surgery Group, Chinese Society of Surgery, Chinese Medical Association. Guidelines for the diagnosis and treatment of deep vein thrombosis (third edition)[J]. Chin J Gen Surg, 2017, 9(4):250-257.
[6]	倪其泓, 郭相江, 杨硕菲, 等. 小腿深静脉入路经皮机械血栓清除治疗全下肢型急性深静脉血栓形成的安全性及疗效分析[J]. 中华医学杂志, 2022, 102(7):486-490.
	NI Q H, GUO X J, YANG S F, et al. Safety and efficacy of percutaneous mechanical thrombectomy through ipsilateral calf venous access in the treatment of entire-limb acute deep venous thrombosis[J]. Natl Med J China, 2022, 102(7):486-490.
[7]	ATTARAN R R, OZDEMIR D, LIN I H, et al. Evaluation of anticoagulant and antiplatelet therapy after iliocaval stenting: factors associated with stent occlusion[J]. J Vasc Surg Venous Lymphat Disord, 2019, 7(4):527-534. doi: S2213-333X(19)30151-9 pmid: 31203859
[8]	NI Q, ZHAO Y, XUE G, et al. Directional femoral ultrasound-guided compression technique using in percuta-neous mechanical thrombectomy for acute deep vein thrombosis: a retrospective cohort study[J]. J Endovasc Ther, 2024,26:15266028241266223.
[9]	倪其泓, 薛冠华, 郭相江, 等. AngioJet改进入路治疗全下肢型急性深静脉血栓形成[J]. 中华普通外科杂志, 2020, 35(4):304-308.
	NI Q H, XUE G H, GUO X J, et al. Modified approach improves the clinical efficacy of AngioJet in treatment of whole-lower-limb acute deep vein thrombosis[J]. Chin J Gen Surg, 2020, 35(4):304-308.
[10]	NI Q, LONG J, GUO X, et al. Clinical efficacy of one-stage thrombus removal via contralateral femoral and ipsilateral tibial venous access for pharmacomechanical thrombectomy in entire-limb acute deep vein thrombosis[J]. J Vasc Surg Venous Lymphat Disord, 2021, 9(5):1128-1135.
[11]	MAKEDONOV I, KAHN S R, GALANAUD J P. Prevention and management of the post-thrombotic syndrome[J]. J Clin Med, 2020, 9(4):923.
[12]	张福先. 静脉血栓栓塞症诊治的最新关注[J]. 外科理论与实践, 2019, 24(4):293-296.
	ZHANG F X. The latest attention on the diagnosis and treatment of venous thromboembolism[J]. J Surg Concepts Pract, 2019, 24(4):293-296.
[13]	VEDANTHAM S, GOLDHABER S Z, JULIAN J A, et al. Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis[J]. N Engl J Med, 2017, 377(23):2240-2252.
[14]	张涛, 吴书圣, 秦士勇, 等. 股深动脉血运重建治疗下肢缺血的应用现状[J]. 中华普通外科杂志, 2022, 37(1):74-77.
	ZHANG T, WU S S, QIN S Y, et al. Application status of deep femoral artery revascularization in the treatment of lower limb ischemia[J]. Chin J Gen Surg, 2022, 37(1):74-77.
[15]	BROHOLM R, BÆKGAARD N, HANSEN S, et al. Significance of partial or complete thrombosis of the common and deep femoral vein in patients with deep vein thrombosis[J]. Eur J Vasc Endovasc Surg, 2019, 58(4):570-575.
[16]	QAMHAWI Z, KEARNS D, WILTON E, et al. Thrombectomy of the profunda femoral vein in iliofemoral deep venous thrombosis using an antegrade popliteal approach[J]. Cardiovasc Intervent Radiol, 2024, 47(3):379-385.