To investigate the safety, feasibility and effectiveness of AngioJet one-stop treatment for acute lower extremity deep vein thrombosis (DVT) patients via deep lower leg vein approach.

Twenty-three patients with acute DVT of the whole limb type in our hospital were retrospectively selected. All patients underwent AngioJet one-stop thrombectomy through the deep vein approach of the affected lower leg. The success rate, general situation of the surgical technique, complications such as bleeding at the puncture point of the lower leg and secondary bleeding caused by urokinase application in other organs were observed, and the patency of the affected limb was followed up. The levels of glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, blood creatinine and blood urea were compared before and after operation.

Twenty-three patients with acute DVT of lower extremities were successfully treated with AngioJet one-stop thrombectomy via deep lower leg vein approach, with the technical success rate of 100%. There were 6 cases (26.1%) via peroneal vein, 8 cases (34.8%) via anterior tibial vein, and 9 cases (39.1%) via posterior tibial vein. The intraoperative blood loss ranged from 69 to488 mL, with an average of (255 ± 108) mL. Twenty-one cases (91.3%) were opened in the first stage, and 2 cases (8.7%) were opened in the second stage after catheter thrombolysis because of more thrombus residues. The overall thrombus clearance rate was grade Ⅲ in 14 cases (60.8%) and grade Ⅱ in 9 cases (39.2%). Nineteen cases (82.6%) were combined with balloon dilatation of iliac vein, and 15 cases (65.2%) were implanted with stent. Fifteen cases (65.2%) had transient hematuria after operation, and no serious complications such as leg puncture site bleeding and secondary bleeding caused by urokinase application in other organs occurred during and after operation. All patients' lower limb swelling symptoms were effectively relieved. There were no significant differences in glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, blood creatinine and blood urea before and after operation (P > 0.05). Follow up for 6 to 42 months showed that the primary patency rate of iliofemoral vein was 91.3% (21/23) 12 months after operation, and deep vein thrombosis recurred in 2 cases (8.7%). One case developed mild post thrombotic syndrome during follow-up, which improved after prolonged anticoagulation and elastic stockings pressure treatment.

It is safe, feasible and effective to perform AngioJet one-stop treatment for acute DVT of whole limb type through deep vein of lower leg.