Amplatz血栓切割器的研究

A research on the amplatz thrombectomy device

目的：评估Ａｍｐｌａｔｚ血栓切割器的安全有效性。方法：用人体血液制备成４天或１０天血凝块，采用转速为８００００ｒｐｍ、１０００００ｒｐｍ和１２００００ｒｐｍ，时间为３０ｓ切割，然后用不同网径过滤称重得到切割后血栓颗粒大小分布，并对１０例股浅动脉或人造血管血栓病人进行血栓切割，采用转速１０００００ｒｐｍ，时间为３２～３３０ｓ。结果：以转速８００００ｒｐｍ、１０００００ｒｐｍ和１２００００ｒｐｍ切割血栓后，颗粒小于１５μｍ占总重量分别为９４．２０％、９６．２９％和９４．７０％。４ｄ和１０ｄ血凝块切割后，颗粒大于１５μｍ分别为５．１６％和４．７８％。临床应用中，１０例病人有８例获取完全成功，２例部分成功。结论：Ａｍｐｌａｔｚ血栓切割器对急性、亚急性血栓切割安全有效，尤其对人造血管内的血栓有效。

Purpose: To evaluate the safety and efficacy of Amplatz thrombectomy device (ATD) for macerating acute or subacute thrombi. Methods: Four and 10 day old clots made from human blood were macerated by ATD at speeds of 80000rpm, 100000rpm and 120000rpm within 30 seconds of activation time. The macerated clot particles filtrated through filters of various diametrns were weighted to demonstrate the distribution and size of the macerated particles. Also, the ATD was used in ten patients with acutely or subacutely occluded lower extremity bypass grafts (n=6) or superficial femoral arteries (n=4). Results: Percentages of total particles >15μm at speeds of 80000rpm, 100000rpm and 120000rpm were 5.80%, 3.81% and 5.30%. The thrombi were completely removed in eight patients (six bypass grafts and two native superficial femoral arteries). In two patients with occlusions of superficial femoral artery,the thrombus was partially removed. Conclusion: Amplatz thrombectomy device is safe and efficient for removing the acute or subacute thrombi,particularly that in bypass grafts in which organization does not occur.