Abstract:Objectiv To investigate the efficacy and safety of Acostream percutaneous aspiration thromboembolectomy (PAT) sequential low-dose alteplase (rt-PA) in the treatment of lower extremity deep vein thrombosis(LEDVT). Methods The clinical data of 22 patients with LEDVT admitted to Nanjing First Hospital from June 2022 to March 2024 were retrospectively analyzed. Data on procedure-related parameters, parameters of combined low-dose rt-PA use, hospital stay, thrombus clearance rate, swelling rate of the affected limb, hemoglobin changes at 48 h after operation, and complications were recorded. Results The thrombus aspiration time was 1.7(1.4,2.7) min. Immediate post-PAT grade Ⅲ thrombus clearance was achieved in 3 cases (13.6%), grade Ⅱ clearance in 18 cases (81.8%), and grade Ⅰ clearance in 1 case (4.5%). Sequential rt-PA thrombolysis had a thrombolytic time of (51.1±14.6)h and a dose of 21.0(20.0,36.5)mg, with grade Ⅲ clearance in 14 cases (63.6%), grade Ⅱ clearance in 7 cases (31.8%), and grade Ⅰ clearance in 1 case (4.5%). The hospital stay was (10.4±3.2)d. After thrombolytic therapy, the reduction in thigh circumference was (1.7±0.8)cm, and the reduction in calf circumference was 0.8 (0.5,1.3)cm. Small bleeding events occurred in 7 patients during hospitalization. No new renal function impairment, allergic reactions, or severe complications were observed. After 6 months of follow-up, thrombosis recurred in 1 patient after the initial treatment, and 1 patient developed mild post-thrombotic syndrome 6 months post-procedure; the mean Villalta score was 2(1,2) for the 22 patients. Conclusion Acostream mechanical thrombectomy followed by low-dose rt-PA can rapidly reduce thrombus burden and restore limb blood flow, and it is preliminarily assessed as a safe and effective treatment for LEDVT patients.