摘要
目的探讨导管接触性溶栓(catheter-directed thrombolysis,CDT)治疗下腔静脉滤器血栓形成(inferior vena cava filter thrombosis,IVCFT)的有效性和安全性。方法回顾性分析2014年1月~2019年11月CDT治疗27例IVCFT的临床资料。结果放置CDT导管操作时间(42±12)min,溶栓治疗时间48~144 h(中位数96 h)。复查下腔静脉造影提示滤器内血栓完全溶解20例;残留血栓最大直径≤1 cm 5例;2例残留血栓最大直径分别为1.7 cm、1.9 cm。24例(88.9%)滤器完整取出;未取出3例,包括残留血栓最大直径>1 cm 2例,≤1 cm 1例。CDT及滤器回收过程中无并发症发生。随访(16.4±0.7)月,24例滤器成功回收者定期复查下腔静脉彩色多普勒超声,均提示管腔通畅;3例滤器未能回收者随访期间病情稳定。无血栓复发及出血性事件发生。结论CDT治疗IVCFT安全、有效,滤器取出率高,避免滤器长期存留体内。
Objective To investigate the effectiveness and safety of catheter-directed thrombolysis(CDT)for inferior vena cava filter thrombosis(IVCFT).Methods The clinical data of 27 cases of IVCFT underwent CDT treatment in our department from January 2014 to November 2019 were analyzed retrospectively.Results The average time of CDT operation was(42±12)min,and the median time of thrombolysis was 96(48-144)hours.After CDT treatment,the angiography showed that IVCFT was completely thrombolysed in 20 cases and partially thrombolysed in 7 cases,in cluding 5 cases with the maximum diameter of residual thrombus≤1 cm and 2 cases 1.7 cm and 1.9 cm respectively.The filter was completely removed in 24 cases(88.9%);the filter was not removed in 3 cases,including 2 cases with the maximum diameter of residual thrombus>1 cm and 1 case≤1 cm.No related complications occurred during CDT and filter recovery.All the patients were followed up after surgery.The average follow-up time was(16.4±0.7)months.A total of 24 cases with successful filter removal were regularly reviewed with the color Doppler ultrasound of the inferior vena cava,all of which indicated that the lumen was unobstructed.Three patients who failed to remove the filter were in stable condition during the follow-up period.There was no thrombus recurrence or bleeding during the follow-up period.ConclusionCDT for IVCFT is a safe and effective treatment method,which can significantly improve the filter removal rate and avoid various serious complications due to long-term implantation of the filter in the body.
作者
战激光
赵堂海
解远峰
张杰
逄晓军
秦少华
Zhan Jiguang;Zhao Tanghai;Xie Yuanfeng(Department of Vascular Surgery, The 970th Hospital of the PLA Joint Logistic Support Force, Yantai 264002, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2020年第8期726-729,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
下腔静脉滤器
血栓
导管接触性溶栓
滤器取出率
Inferior vena cava filter
Thrombosis
Catheter-directed thrombolysis
Filter removal rate
