血管腔内治疗慢性下肢缺血时的溶栓治疗

Catheter-directed thrombolysis for the treatment of chronic limb ischemia before endovascular therapy

目的探讨导管溶栓在慢性下肢缺血腔内成形治疗时的可行性、疗效及安全性。方法回顾性分析2009年2月～2011年2月在广州市中医院接受治疗的11例慢性下肢缺血(TASCⅡD级)患者的临床资料。采用尿激酶(UK)溶栓,然后再行血管腔内治疗,对治疗后临床疗效及动脉通畅率进行统计分析。结果 9例患者(81.8%)血管成形技术获得成功,无并发症发生;2例(18.2%)未溶栓成功。8例患者获得随访,随访率为88.9%,平均随访时间14.5个月。术后1年一期通畅率、辅助一期通畅率和二期通畅率分别为80%、88%及92%,2年为67%、84%及88%。结论对慢性下肢缺血TASCⅡD级病变进行血管腔内成形时的溶栓是可行、安全且有效的。

Objective To evaluate the feasibility, safety and efficacy of catheter-directed thrombolysis in treating chronic limb ischemia(CLI)before endovascular angioplasty. Methods From Feb. 2009 to Feb. 2011, the clinical data of 11 CLI patients (TASC Ⅱ D) who treated in Guangzhou hospital of traditional Chinese medicine were reviewed. Patients were received catheter-directed thrombolysis with urokinase before endovascular angioplasty. Results 9 cases were successfully treated without complications,and technical success rate was 81.8%, 2 cases(18.2%) was failed. Eight patients were followed up for a mean time of 14.5 months. Primary, assisted-primary, and secondary patency rates was 80%, 88% and 92% at 1 year, respectively, 67%, 84% and 88% at 2 years, respectively. Conclusion Catheter-directed thrombolysis in treating CLI (TASC Ⅱ D) before endovascular angioplasty is creditable, safe and effective.