Thrombolysis with different approaches combined with interventional surgery in patients with iliac vein compression syndrome comorbid with acute deep vein thrombosis: a comparative study

Peng Wei; Ding Jinhui; Chen Zhiyong; Cao Zichuan; Wang Xiao

doi:10.13406/j.cnki.cyxb.003947

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Thrombolysis with different approaches combined with interventional surgery in patients with iliac vein compression syndrome comorbid with acute deep vein thrombosis: a comparative study

Clinical research | 更新时间：2026-02-13

- Thrombolysis with different approaches combined with interventional surgery in patients with iliac vein compression syndrome comorbid with acute deep vein thrombosis: a comparative study
- Journal of Chongqing Medical University Vol. 51, Issue 1, Pages: 139-145(2026)
- 作者机构：
  
  1.安徽医科大学第一附属医院放射科，合肥 230032
  2.安徽省第二人民医院介入血管外科，合肥 230041
  3.安徽医科大学第一附属医院血管外科，合肥 230032
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003947
  CLC： R81;R815
- Received：05 February 2025，
  
  Revised：2025-05-26，
  
  Published：28 January 2026
- 稿件说明：
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彭伟,丁锦辉,陈智勇等.不同入路置管溶栓结合介入手术在IVCS并发急性DVT患者中的比较研究[J].重庆医科大学学报,2026,51(01):139-145.

Peng Wei,Ding Jinhui,Chen Zhiyong,et al.Thrombolysis with different approaches combined with interventional surgery in patients with iliac vein compression syndrome comorbid with acute deep vein thrombosis: a comparative study[J].Journal of Chongqing Medical University,2026,51(01):139-145.
彭伟,丁锦辉,陈智勇等.不同入路置管溶栓结合介入手术在IVCS并发急性DVT患者中的比较研究[J].重庆医科大学学报,2026,51(01):139-145. DOI： 10.13406/j.cnki.cyxb.003947.

Peng Wei,Ding Jinhui,Chen Zhiyong,et al.Thrombolysis with different approaches combined with interventional surgery in patients with iliac vein compression syndrome comorbid with acute deep vein thrombosis: a comparative study[J].Journal of Chongqing Medical University,2026,51(01):139-145. DOI： 10.13406/j.cnki.cyxb.003947.

摘要

目的

分析不同入路置管溶栓方式结合介入手术在髂静脉压迫综合征（iliac vein compression syndrome，IVCS）并发急性下肢深静脉血栓（deep venous thrombosis of lower extremity，DVT）患者中的应用对比。

方法

回顾性选取2019年4月至2024年4月在安徽医科大学第一附属医院血管外科及安徽省第二人民医院介入血管外科接受治疗的80例IVCS并发急性DVT患者为研究对象。依据治疗方法将其分为2组，对照组（

=40）采用腘静脉入路置管溶栓+机械吸栓+球囊扩张+植入支架治疗，观察组（

=40）采用胫前或胫后入路置管溶栓+机械吸栓+球囊扩张+植入支架治疗。对比观察2组患者在置管成功率、不良事件、深静脉溶栓效果、疼痛、血栓后综合征以及静脉临床严重程度评分（venous clinical severity score，VCSS）方面的差异。

结果

①对照组和观察组的置管成功率均为100%，差异无统计学意义（

0.05）。②2组不良事件发生差异有统计学意义（

0.05），观察组穿刺点渗血和腰部疼痛/酸胀的发生率为0.00%、5.00%，均低于对照组的15.00%、7.50%，观察组总发生率为7.50%，低于对照组的25.00%，2组血红蛋白降低的发生率未发生改变。③2组患肢深静脉溶栓效果差异有统计学意义（均

0.05），观察组溶栓时间为（3.60±1.13） d，溶栓效果评分为（0.75±0.26）分以及患肢健肢大腿周径差（1.01±0.27） cm，均低于对照组的（4.83±2.21） d、（1.18±0.87）分、（1.82±0.66） cm，深静脉再通率（95.63±6.90）%和患肢消肿率（96.88±5.02）%均高于对照组［（91.75±7.23）%、（93.75±6.50）%］。④2组疼痛差异有统计学意义（

0.05），观察组视觉模拟评分法（visual analogue scale，VAS）评分为（2.38±0.49）分，低于对照组的（2.65±0.50）分。⑤2组血栓后综合征差异有统计学意义（

0.05），观察组Villalta评分为（1.58±2.43）分，低于对照组的（2.76±1.90）分。⑥观察组VCSS下降幅度差异为（13.85±2.57）分，高于对照组的（10.22±1.80）分（

0.05）。

结论

胫前或胫后入路置管溶栓方式结合介入手术在治疗IVCS并发急性DVT可在未降低置管成功率的前提下改善其他指标，降低不良事件的发生风险，提高治疗效果。

Abstract

Objective

To investigate the application of thrombolysis with different approaches combined with interventional surgery in patients with iliac vein compression syndrome（IVCS） comorbid with acute deep vein thrombosis（DVT） of lower limbs.

Methods

A retrospective analysis was performed for 80 patients with IVCS comorbid with acute DVT who were treated in Department of Vascular Surgery，The First Affiliated Hospital of Anhui Medical University and Department of Interventional Vascular Surgery，Anhui No. 2 Provincial People’s Hospital from April 2019 to April 2024，and they were divided into control group and observation group according to the treatment method，with 40 patients in each group. The patients in the control group received catheter-directed thrombolysis via the popliteal vein approach，mechanical thrombectomy，balloon dilatation，and stent implantation，and those in the observation group received catheter-directed thrombolysis via the anterior or posterior tibial vein approach，mechanical thrombectomy，balloon dilatation， and stent implantation. The two groups were compared in terms of catheterization success rate，adverse events， the treatment outcome of deep vein thrombolysis，pain，post-thrombotic syndrome，and venous clinical severity score（VCSS）.

Results

The catheterization success rate was 100% in both the control group and the observation group， with no significant difference between the two groups（

0.05）. There was a significant difference in the incidence rate of adverse events between the two groups（

0.05）；the incidences of bleeding at the puncture point and lumbar pain/soreness and distension in the observation group were 0.00% and 5.00%，respectively，which were lower than 15.00% and 7.50% in the control group. The total incidence in the observation group was 7.50%，which was lower than 25.00% in the control group. The incidence of decreased hemoglobin in both groups remained unchanged. There was a significant difference in the treatment outcome of intravenous thrombolysis between the two groups（

0.05）；the thrombolysis time （3.60±1.13） days，thrombolysis effect score（0.75±0.26） points，and the difference in thigh circumference between the affected limb and the healthy limb（1.01±0.27） cm in the observation group were all lower than those in the control group[（4.83±2.21） days，（1.18±0.87） points，（1.82±0.66） cm

]

. The deep vein recanalization rate（95.63±6.90）% and the swelling reduction rate of the affected limb（96.88±5.02）% were both higher than those of the control group（91.75±7.23）% and （93.75±6.50）%，respectively. There was a significant difference in pain between the two grou

ps（

0.05），and the visual analogue scale（VAS） score of the observation group（2.38±0.49） points was lower than that of the control group（2.65±0.50） points（

0.05），and Villalta score decreased from 2.76±1.90 to 1.58±2.43. The observation group had a significantly greater reduction in VCSS than the control group（13.85±2.57 vs. 10.22±1.80，

0.05）.

Conclusion

In the treatment of IVCS comorbid with acute DVT，catheter-directed thrombolysis via the anterior or posterior tibial approach combined with interventional surgery can improve related indicators， reduce the risk of adverse events， and improve the treatment outcome， without reducing catheterization success rate.

关键词

Keywords

references

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Value of computed tomography venography/angiography of both lower extremities via both great saphenous veins in the imaging diagnosis of iliac vein compression syndrome

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