Research on interventional treatment strategies for lower extremity deep venous thrombosis based on real-world data

Objective Current treatment strategies for acute lower extremity deep vein thrombosis (DVT) have shifted from merely preventing pulmonary embolism to actively removing thrombus and preserving valve function. However, there is limited evidence comparing the indications and perioperative outcomes of different endovascular strategies. This study aims to investigate the differences in indications, perioperative characteristics, and efficacy trends among three strategies: Angiojet mechanical thrombectomy alone, other thrombus removal devices alone, and a combination of Angiojet with other devices. Methods A retrospective analysis was conducted on the clinical data of 232 DVT patients who underwent endovascular treatment in the Vascular Surgery Department of our hospital between January 2022 and April 2025. Based on the core thrombus removal method, patients were divided into three groups: Group A (Angiojet alone, n = 22), Group B (other devices alone, including manual aspiration and catheter-directed thrombolysis CDT, n = 35), and Group C (Angiojet combined with other devices, n = 175). Baseline characteristics, thrombus anatomical extent, and perioperative parameters were compared across the groups. Chi-square test, analysis of variance, or Kruskal–Wallis test were used for intergroup comparisons. Results There were fundamental differences in thrombus burden among the three groups ( P 0.001). Groups A and B primarily treated limited (femoral/popliteal) thrombosis (50.0% and 51.4%, respectively), while Group C was the predominant approach for extensive thrombosis (iliofemoral-popliteal, 50.9%) and thrombosis involving the inferior vena cava (22.3%). The operative time for Group C (134 ± 48 min) was significantly longer than for Group A (98 ± 36 min) and Group B (115 ± 45 min) ( P 0.001), and blood loss (66 ± 39 mL) was also higher compared to the other two groups ( P = 0.008). In terms of treatment intensity, the balloon angioplasty rate (96.0%) and stent implantation rate (58.9%) in Group C were significantly higher than in Groups A and B ( P 0.001). Group B showed the highest trend for documented “partial thrombus residue” (22.9%). Conclusion Current endovascular DVT treatment has formed a clear risk-stratified decision-making pathway. Angiojet alone is an efficient and streamlined option for limited acute DVT; for extensive and complex DVT, the intensified strategy of Angiojet combined with other thrombus removal devices has become the standard choice, with its longer operative time and higher rate of vascular interventions reflecting disease complexity. This study provides real-world evidence for individualized endovascular DVT treatment.