Purpose: The usefulness of percutaneous transluminal angioplasty (PTA) on chronic deep venous thrombosis is little known. Thus the authors decided to treat aggressively chronic deep venous thrombosis which did not get better after using anticoagulants for more than six months and to evaluate the utility of PTA and stent insertion, complications in administration, and short-term treatment results.
Method: Fifteen patients, who did not get better and developed chronic deep venous thrombosis after anticoagulation from August 1987 to December 2001, were selected and conducted with local thromobolytics, PTA, and stent insertion. Patients’ age, sex, incidence by region, the period of anticoagulant treatments, symptom before thrombolytic agents therapy, degree of lysis, the period of anticoagulants therapy and its relationship with involved vein, and complications were analyzed into two groups: in case of successful treatment (Group Ⅰ) and failing (Group Ⅱ).
Result: Male were 10 and female were 5, and left limb were 12 cases and right limb 3 in the attacked region. The period of anticoagulants therapy was ranged from 6 months to 13 years 6 months with mean 45 months. Of the symptom, before thrombolytic agents therapy, edema was most frequent, followed by pain, edema accompanied with pain, pigmentation, venous claudication, and ulcer. In thrombus location, two groups were significantly different in some cases: Group Ⅰ was located in external iliac vein(8), common iliac vein(6), common femoral vein(6), and femoral vein(1), while Group Ⅱ was located in external iliac vein(7), common iliac vein(6), common femoral vein(6), femoral vein(6), and popliteal vein(5). After treatment, Group Ⅰ was improved gradually from 1 week after treatment, especially limb edema, pain, and venous claudication. In complication, local hemorrhage of venipuncture region(1) and chest pain and dyspnea(1) happened but there was no significant finding in a lung scanning.
Conclusion: There was no significant correlation in age, the ratio of sex, predisposing factor, treatment period before deep venous thrombosis therapy, clinical symptoms, and whether treatment is successful or not between successful and failing group. The case of limited thrombus to iliac or thigh vein showed better prognosis.
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