Abstract:

Abstract: Objective To estimate the risk of bleeding after thrombolytic therapy in patients with secondary deep venous thrombosis, in order to find a better therapy for higher bleeding risk postoperative patients. Methods 48 patients diagnosed postoperative DVT were divided into PMT group included 27 patients and CDT group included 21 patients. The PMT group was treated by PMT or PMT+CDT, the CDT group given thrombolysis only directed by catheterization. The effects of thrombus removal and later follow-up effects in the two groups were compared. Results Thrombus degradation was obviously better in PMT group compared with the CDT group [(90.21±17.28)% vs (75.65±27.59)%]. Lower dosage of urokinase [(105.45±126.34)WU vs (345.87±118.38)WU] and shorter hospital stays [(6.72±1.88)d vs (8.82±2.97)d],less time in bed[（2.90±2.71）d vs（ 5.40±2.06）d]was also detected in PMT group patients. There is nonmajor bleeding occurred in both groups. Nonmajor bleeding was higher in PMT group, but they did not achieve statistical significance(P>0.05). In later follow-up, PTS Villalta scores of 12 and 24 months in PMT were better than CDT. Conclusion Both PMT and single CDT were both effective and safety methods in treating postoperative DVT more than one week, associated low bleeding risk，however the strategy combined PMT had the advantage in low dosage of urokinase using, better thrombus eliminating, and reducing the hospital stays and time in bed. Villalta score was lower in PMT-group, connected with lower risk of PTS morbidity.

Key words: Lower extremity deep vein thrombosis, Catheter-directed thrombolysis, Pharmacomechanical thrombectomy