Abstract: Evaluation and treatment strategy of high clot burden thrombosis in lower extremity deep veins        GUO Xiang-jiang, XUE Guan-hua. Department of Vascular Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Corresponding author: XUE Guan-hua, E-mail：guanhuaxue@
yeah.net
Abstract    According to the clot burden, lower extremity deep venous thrombosis can be divided into high clot burden and low clot burden. The incidence of post-thrombotic syndrome (PTS) of high clot burden is high, and the effect of anticoagulation alone is poor. For acute high clot burden deep venous thrombosis, surgeon need to take more active measures to remove thrombus, reduce thrombus load, protect valve function and reduce the incidence of PTS. Percutaneous mechanical thrombectomy (PMT) is a more rapid surgical method to reduce thrombus burden than catheter-directed thrombolysis (CDT). PMT can be used as the first choice for the treatment of deep vein thrombosis. While CDT can be an effective supplement to PMT.

Key words: lower extremity deep venous thrombosis, high clot burden, low clot burden；thrombus evaluation；thrombus removal

摘要： 下肢深静脉血栓根据血栓负荷大小分为高负荷血栓和低负荷血栓。高负荷血栓的中远期深静脉血栓后综合征（PTS）发生率高，单纯抗凝治疗效果较差。对于急性期高负荷血栓，需要采取更加积极的手术祛栓措施，减少血栓负荷，保护瓣膜功能，降低PTS发生率。经皮机械性血栓清除术（PMT）是较导管接触性溶栓（CDT）更加迅速降低血栓负荷的手术方案，PMT可以作为下肢深静脉高负荷血栓的首选治疗方案。而CDT可以作为PMT的有效补充。

关键词: 下肢深静脉血栓形成, 高负荷血栓, 低负荷血栓, 血栓评估, 血栓清除