经小隐静脉置管溶栓治疗下肢深静脉血栓形成

Transcatheter thrombolysis via the small saphenous vein for deep venous thrombosis of lower limb

目的探讨经小隐静脉途径置管直接溶栓治疗下肢深静脉血栓形成的临床应用价值。方法 14例下肢深静脉血栓患者,先行患肢血管造影,明确诊断后,经小隐静脉放置溶栓导管于深静脉血栓段内,微泵持续推注尿激酶直接溶栓。结果 14例下肢深静脉血栓包括中央型8例,混合型6例。溶栓后主干再通,侧支血管增多10例,血栓溶解率71.4%;12例疼痛缓解,肿胀消退,恢复正常劳动力,2例患者肿胀明显减轻,能进行家务劳动。结论经小隐静脉置管直接溶栓治疗下肢深静脉血栓形成是一种安全、有效的治疗方法。

Objective To discuss the clinical value of transcatheter thrombolysis via the small saphenous vein for the treatment of deep venous thrombosis（DVT）of lower extremity.Methods Angiography of the diseased lower limb was performed in 14 patients with suspected DVT of lower limb.When the diagnosis was confirmed,the catheter-directed thrombolosis via the small saphenous vein was carried out through continuous infusion of urokinase with a micro-pump.The clinical symptoms were observed and the therapeutic results were analyzed.Results Of 14 cases with lower extremity DVT,central type DVT was seen in 8 and mixed type in 6.The total success rate of thrombolysis was 71.4%.Trunk re-canalization as well as increased collateral circulation was seen in 10 patients.Alleviation of pain,subsidence of swelling and restoring to normal labor were obtained in 12 patients.Significant subsidence of edema was achieved in the remaining 2 patients and the patients were able to do some household works.Conclusion The catheter-directed thrombolysis via the small saphenous vein is a safe and effective treatment for lower extremity DVT.（J Intervent Radiol,2010,19： 944-946）