Clinical analysis of patients with lower extremity deep venous thrombosis complicated with inferior vena cava thrombus

Objective To explore the clinical profiles of patients with lower extremity deep venous thrombosis (DV T) complicated with inferior vena cava (IVC) thrombus and summarize their clinical diagnostic and therapeutic experiences. Methods The clinical characteristics, diagnosis and treatment of 20 hospitalized patients with DV T complicated with inferior vena cava thrombus were analyzed retrospectively. Results All of them were of proximal DVT.There were phlegmasia cerulea dolens (n=3), pulmonary embolism (n=3) and completely occlusion of IVC (n=5).Clinical manifestations were severe.Retrievable inferior vena cava filter (IVCF) was implanted for 17 cases.Catheter-directed thrombolysis (CDT) through ipsilateral popliteal vein was applied for 7 cases and systemic thrombolysis therapy for 8 cases.The effective rate of thrombolysis for fresh IVC thrombus was 100%.Among 5 cases with Cockett Syndrome, 3 cases underwent balloon dilatation angioplasty and endovascular stenting of iliac vein.And 17 IVCFs were retrieved successfully within 3 weeks.IVC thrombus disappeared completely in 15 cases. Conclusion Systemic or local thrombolysis with protective IVCF is a safe and effective therapy for nonocclusive IVC thrombus in DVT.And CDT is recommended for symptomatic occlusive IVC thrombus. Key words: Venous thrombosis; Lower extremity; Vena cava, inferior; Vena cava filters; Thrombolytic therapy