摘要
目的:探讨数字血管减影(DSA)下机械吸栓配合置管溶栓术对急性髂股静脉血栓形成治疗的安全性和临床疗效。方法:对10例下肢累及髂股静脉血栓病人先置入Celect下腔静脉滤器,然后采用DSA下经患侧腘静脉顺穿置入Aspirex静脉吸栓导管分段吸除髂股静脉内血栓,如髂静脉受压予12mm球囊扩张,后配合unifuse溶栓导管置管溶栓。溶栓24h后造影,酌情髂总静脉置入支架,并维持抗凝治疗6-12个月,术后3-6月回收Celect下腔静脉滤器。结果:10例患者均手术顺利,术后全组患肢症状均明显缓解,3月复查全部患肢髂股静脉通畅,临床症状消失,6月内滤器全部取出,随访期间2例存在下肢深静脉轻度返流现象。结论:DSA下机械导管吸栓配合置管溶栓对急性髂股深静脉血栓治疗具有安全、微创、高效的临床特点,值得临床推广。
Objective：To investigate the effect of DSA guided percutaneous mechanical thrombectomy combinded with catheterdirected thrombolysis on the treatment of acute iliofemoral venous thrombosis.Methods：Firstly,ten patients with femoral venous thrombosis were placed with Celect inferior vena cava filter.Then thrombus were sucked with Aspirex percutaneous mechanical thrombectomy guided by DSA and cooperated with catheter directed thrombolysis by using unifuse infusing cathter.After 24 hours,patients were executed venous phlebography and stenting in common iliac vein selectively.All cases received anticoagulation treatment for 6to 12 months.Inferior vena cava filters were retrieved 3to 6months post-operation.Results：Technical success were achieved in all 10 cases and their limb symptoms were all significantly alleviated.Three months later,the clinical symptoms of all patients disappeared and iliofemoral vein of the lower extremity kept unobstructed.Within 6months,all inferior vena cava filters were totally retrieved.During follow-up visit,slight reflux of deep vein was found in only 2cases.Conclusion：DSA guided percutaneous mechanical thrombectomy combined with catheter directed thrombolysis isasafe,minimal invasive and effective treatment for critical iliofemoral venous thrombosis of the lower extremity,which might be valuable for clinical application.
作者
吴云
梁川
WU Yun LIANG Chuan(Dept. of Vascular Surgery ,Zhongnan Hospital of Wuhan University, Wuhan 430071 ,China)
出处
《武汉大学学报（医学版）》
CAS
2017年第1期138-141,共4页
Medical Journal of Wuhan University
关键词
髂股静脉血栓
机械吸栓
置管溶栓
Iliofemoral Venous Thrombosis
Percutaneous Mechanical Thrombectomy
Catheter Directed Thrombolysis
