摘要
目的 探讨采用导丝捕获技术建立工作导丝通路,介入治疗左髂静脉闭塞合并急性下肢深静脉血栓形成的临床可行性.方法 2009年9月～2012年9月,37例左髂静脉闭塞合并急性下肢深静脉血栓形成,在从右侧股静脉入路行左髂股静脉插管失败的情况下,采用左侧股静脉顺行穿刺成功后将导丝插入至下腔静脉,从右侧引入自制抓捕器将导丝拉出后建立工作导丝通路,沿导丝插入翻山鞘管至左侧髂股静脉内,行Fogarty球囊拉栓,大腔鞘管取栓.结果 37例患者均导丝捕获成功,建立了左、右股静脉工作导丝通路.血栓完全清除34例,部分清除3例.出院时膝上、下15cm处健、患肢周径差降为（1.34±0.47）和（0.94±0.31）cm,与入院比较差异有统计学意义（t=6.24、t=7.09,均P＝0.00）.结论 对于经右股静脉入路插管失败的左下肢深静脉血栓患者,采用双侧股静脉入路建立导丝轨道后再插入翻山鞘的方法,技术成功率高,创伤小,值得临床推广.
Objective To investigate the clinical feasibility of guidewire capture technology to establish work guidewire pathways involved in the treatment of acute left common iliac vein occlusion with lower extremity deep vein thrombosis. Methods A retrospective analysis was performed on 37 cases with acute DVT of left lower limbs in our hospital from September 2009 to September 2012 after left lilac-femoral vein catheterization via the right femoral vein access faied. The guide wire was inserted into the inferior vena cava after antegrade punctured the left femoral vein successfully, then establishing a working guide strands via introducing a homemade wire track in order to capture a guidewire. Fogarty balloon pull clot and large-lumen sheath were used to aspirate thrombi by inserting a cross-over sheath to the left iliac vein along the guidewire. Results The technique in the 37 patients was successful, and the left and right femoral vein work guidewire path was established. The thrombus was completely cleared in 34 cases, partially cleared in 3 cases. The circumference difference between two legs at 15cm above and below knee joint reduced to （1.34±0.47） and （0.94±0.31） cm at discharge, difference was statistically significant compared with admission （ t =19.37, t = 23.99, both P = 0.00）. Conclusion For patients with DVT of left lower limb, when iliac-femoral vein catherization via the right femoral vein access failed, the establishment of wire tack by using bilateral femoral vein approaches for further catherization of left iliac-femoral vein and subsequent thrombectomy is feasible in clinic practice. This technique is safe and minimally invasive with higher success rate.
出处
《医学影像学杂志》
2013年第10期1535-1538,共4页
Journal of Medical Imaging
关键词
下肢深静脉血栓
导丝捕获技术
血栓抽吸
介入治疗
Lower extremity deep venous thrombosis
Guide wire capture technology
Thrombus aspiration
Interven-tional therapy
