AcoStream Thrombus Aspiration in the Treatment of Secondary Ilio-femoral Vein Thrombosis in Trauma Patients: A Retrospective Cohort Study
Authors: He Miao , Jiang Rui , Yang Ruowen , Kong Jie , Li Yan , Liu Zhengli , Mao Qiujin 
Published: September 2024

Abstract

Background
The AcoStream Thrombus Aspiration Catheter, as a negative pressure constant aspiration device, is mainly used for ilio-femoral vein thrombus load reduction, and has gained wider use in clinical practice. However, the use of this device in the treatment of secondary iliofemoral vein thrombosis in trauma patients has not been systematically studied.
Objective
This study compared the clinical efficacy and prognosis of Catheter-directed thrombolysis (CDT) and AcoStream Thrombus Aspiration (ATA) combined with CDT in patients with acute iliofemoral vein thrombosis secondary to trauma. This study provides clinical recommendations for the treatment of acute iliofemoral vein thrombosis secondary to trauma.
Methods
A total of 60 cases of acute iliac-femoral vein thrombosis presenting within 14 days of trauma from June 2021-October 2023 were retrospectively analysed in our centre. A total of 49 patients who underwent CDT met the inclusion criteria. Patients were treated with CDT and AcoStream mechanical thrombus aspiration combined with CDT in our department. According to the different treatments, the patients were divided into two groups, including 20 cases in the CDT group and 29 cases in the AcoStream combined CDT group. Thrombolytic drug use, clinical symptoms, thrombus clearance rate, complication occurrence, Villalta score and follow-up effects were collected and statistically analysed using t-test for quantitative data and chi-square test or Fisher's exact test for qualitative data.
Results
All 49 patients underwent successful interventions, and the 15-cm circumferential difference between the suprapatellar diameters of both lower limbs before discharge was significantly better in both groups of CDT and ATA combined with CDT compared with the preoperative period. The thrombus clearance rates of the two groups were 71.35%±21.80% and 75.64%±18.72%, respectively, and the ATA + CDT group showed a statistically significant increase in the thrombus clearance rate compared with the CDT group(F = 3.641, P < 0.05).The ATA + CDT group reduced the amount of thrombolytic medication(F = 5.403, P < 0.05) and shortened the time of thrombolysis(F = 12.830, P < 0.05), which was statistically significant compared with the CDT group. No serious complications occurred in this study between the two treatment modalities. During postoperative follow-up, the incidence of post-thrombosis syndrome(PTS) was lower in all of them, showing better near- and long-term follow-up.
Conclusion
Iliac-femoral vein thrombosis is a common complication in post-traumatic patients. Treatment with ATA combined with CDT can improve the thrombus clearance rate of iliofemoral vein thrombosis, reduce the thrombus load as soon as possible, shorten the thrombolytic time, reduce the use of thrombolytic drugs, and reduce the risk of bleeding. This is a safe and effective treatment for iliofemoral vein thrombosis and can be promoted in the clinic.