AngioJet机械吸栓辅助治疗急性下肢深静脉血栓形成

AngioJet mechanical thrombectomy in treatment of acute deep venous thrombosis of lower extremities

目的评价AngioJet经皮机械吸栓(percutaneous mechanical thrombectomy,PMT)治疗急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的疗效。方法回顾性分析青岛市市立医院血管外科于2015年12月至2018年6月期间收治的行AngioJet机械吸栓治疗的72例(72条肢体)急性下肢DVT患者的临床资料。结果 72例均行PMT治疗,42例行PMT联合导管接触性溶栓(catheter directed thrombolysis,CDT)治疗。其中Ⅲ级溶栓49例(68.05%),Ⅱ级溶栓20例(27.78%),Ⅰ级溶栓3例(4.17%);35例合并左髂静脉压迫综合征者,置入髂静脉支架34例,术中并发髂静脉破裂出血1例。术后3个月、6个月、1年及2年随访患者的PTS发生率分别为1.41%(1/71)、3.57%(2/56)、4.55%(2/44)及20.00%(3/15);术后1年和2年,随访患者的髂股静脉通畅率分别为86.36%(38/44)和80.00%(12/15),髂静脉支架通畅率分别为100%(23/23)和87.50%(7/8)。结论机械吸栓辅以CDT治疗急性下肢DVT的疗效满意,远期效果尚待进一步观察。

Objective To evaluate the effect of percutaneous mechanical thrombectomy(PMT)with AngioJet mechanical thrombus aspiration system for the acute deep venous thrombosis(DVT)of lower extremities.Methods The clinical data of 72 patients(72 limbs)with acute DVT who underwent PMT with AngioJet system from December 2015 to June 2018 in our hospital were analyzed retrospectively.Results Of the 72 cases,30 cases underwent PMT alone,while42 cases underwent PMT combined with catheter directed thrombolysis(CDT).Thrombus clearance rate of gradeⅢwas obtained in 49 cases(68.05%),gradeⅡin 20 cases(27.78%),and gradeⅠin 3 cases(4.17%).Thirty-five cases were found with May-Thurner syndrome,and 34 cases were treated with stenting while 1 case complicated with iliac bleeding.The rates of PTS were 1.41%(1/71),3.57%(2/56),4.55%(2/44),and 20.00%(3/15)at 3-month,6-month,1-year,and 2-year after intervention,respectively.The deep vein patency rates were 86.36%(38/44)and 80.00%(12/15)at 1-year and 2-year after intervention,respectively.The iliac stent patency rates were 100%(23/23)and 87.50%(7/8)at 1-year and 2-year after intervention,respectively.Conclusion The effect of PMT assisted with CDT for the acute DVT of lower extremities is satisfactory,but its long-term efficacy needs to be further observed.