摘要
目的探讨AngioJet血栓清除系统治疗有溶栓禁忌的急性下肢深静脉血栓形成(DVT)的效果及经颈静脉途径特点。方法对24例有溶栓禁忌的急性DVT患者施行经右颈静脉途径DSA造影、下腔静脉滤器置入、AngioJet血栓抽吸、经皮腔内血管成形(PTA)、支架植入、取出滤器。观察血栓抽吸疗效及手术相关并发症。结果24例患者AngioJet血栓清除治疗均获得成功。其中21例(87%)血栓清除为Ⅲ级,3例(13%)为Ⅱ级。19例(79%)置入下腔静脉滤器并全部取出。7例(29%)伴有髂静脉受压综合征患者接受PTA,其中3例(43%)植入支架。所有患者均出现不同程度血红蛋白尿,22例48 h内消失,2例72 h内恢复正常,均未出现大出血、肾衰竭等严重并发症。术后随访6~12个月,1例失访,1例复发。结论经颈静脉途径AngioJet血栓清除系统治疗有溶栓禁忌的急性DVT安全可行,疗效好,并发症少。
Objective To investigate the efficacy of AngioJet,a thrombus clearance system,in treating acute deep vein thrombosis(DVT)of lower extremity in patients with contraindication to thrombolytic therapy,and to discuss the technical characteristics of transjugular approach.Methods A total of 24 patients with acute DVT,who had contraindication to thrombolytic therapy,underwent DSA,inferior vena cava filter placement(IVCFI),AngioJet thrombus aspiration,percutaneous transluminal angioplastry(PTA),stent implantation and filter removal,all of which were performed via the right jugular access.The effect of thrombus aspiration and procedure-related complications were evaluated.Results Successful thrombus removal with AngioJet device was accomplished in all the 24 patients.Thrombus clearance rate of grade Ⅲ was achieved in 21 patients(87%)and thrombus clearance rate of grade Ⅱ in 3 patients(13%).In 19 patients(79%)IVCFI implantation was performed and all of the filters were successfully retrieved.Seven patients(29%)with iliac vein compression syndrome received PTA,in 3(43%)of them stent implantation was employed.After treatment,all patients developed varying degrees of hemoglobinuria,which disappeared within 48 hours in 22 patients and returned to normal within 72 hours in other 2 patients.No severe complications such as massive hemorrhage or renal failure occurred.The patients were followed up for 6-12 months,one patient was lost in touch and another patient had a relapse.Conclusion For the treatment of acute DVT,AngioJet device via the right jugular access is clinically safe,feasible and effective with less complications.
作者
吕墩涛
徐浩
王文亮
刘洪涛
LV Duntao;XU Hao;WANG Wenliang;LIU Hongtao(Department of Interventional Radiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province 221002,China)
出处
《介入放射学杂志》
CSCD
北大核心
2021年第9期925-928,共4页
Journal of Interventional Radiology
