Surgical treatment of acute deep vein thrombosis in the lower limbs: a single-center cohort study in Vietnam

Objectives: To evaluate the outcomes of early removal of acute deep vein thrombosis (DVT) in the lower limbs through thrombectomy and thrombolysis. Methods: This is a retrospective cohort study that included patients with acute iliofemoral DVT. The patients were divided into two groups: thrombectomy and thrombolysis. Immediate-, short-, and mid-term outcomes were assessed at 24 hours, 1 month, and 6 months post-intervention, respectively. Results: In total, 115 patients were included in this study, comprising 65 who underwent thrombectomy and 50 who underwent thrombolysis. Successful revascularization rates in the thrombectomy vs. thrombolysis groups were 95.2% vs. 100.0% at the immediate-term ( P = 0.253), 92.3% vs. 86% at the short-term ( P = 0.619), and 75.4% vs. 92% at the mid-term ( P = 0.020). Complication rates in the thrombectomy vs. thrombolysis groups were 23.1% vs. 10% at the immediate-term ( P = 0.084), 27.7% vs. 16% at the short-term ( P = 0.180), and 7.7% vs. 0.0% at the mid-term ( P = 0.068). Compared to those of thrombectomy, thrombolysis had advantages in terms of intervention duration (72.5 vs. 105.0 minutes, P < 0.001), blood loss (150.0 vs. 200.0 mL, P = 0.003), length of stay (8.0 vs. 10.0 days, P < 0.001), and significant symptom relief at short-term (60.0% vs. 38.5%, P = 0.047), with a trend toward greater symotom relief at mid-term (64.0% vs. 42.2%, P = 0.075). Conclusions: Both thrombectomy and thrombolysis are highly effective and safe for early removal of acute DVT of the lower limbs. Thrombolysis appears to offer advantages over thrombectomy in terms of intervention duration, blood loss, length of hospital stay, and symptom relief.