18例LEAE的腔内介入治疗体会

Endovascular Interventional Treatment 18 Cases of LEAE

目的:评价腔内介入治疗下肢动脉栓塞(LEAE)的临床疗效和安全性。方法:回顾性分析18例LEAE患者的临床资料,总结LEAE的腔内介入治疗方法及疗效。结果:18例Seldinger穿刺留置导管抽吸出血栓,单纯导管抽栓治疗11例,导管抽栓+尿激酶溶栓治疗4例,导管抽栓+球囊扩张治疗2例,导管抽栓+支架治疗1例。18例患者均顺利开通栓塞动脉,但4例抽栓后破碎的小栓子脱落栓塞远端血管或远端血管血栓形成,采用抽栓联合尿激酶溶栓治疗后,4例完全开通栓塞的远端血管,2例部分开通栓塞远端血管,2例溶栓后远端血管仍不能开通,但侧支循环较前明显增多。随访5.2±5.3个月,15例患者下肢缺血症状完全消失,2例患者栓塞侧足部皮温降低、肤色苍白、末梢血运差,1例截肢治疗。结论:腔内介入治疗下肢动脉栓塞具有微创、简便、安全的特点,可降低患肢缺血、坏死的发生率,疗效明显。

Purpose：To evaluate the clinical efficacy and safety of endovascular interventional treatment of lower limb arterial embolism （LEAE）.Methods：Clinical data of 18 cases of LEAE patients were retrospective analyzed.These patients were undergone interventional therapy and the effect of the therapy was summarized.Results：Thrombosis suction was undergone in 18 cases by Seldinger method,11 cases of them were simple catheter thrombosis suction,4 cases were catheter thrombosis suction ＋ urokinase thrombolytic therapy,2 cases were catheter thrombosis suction ＋ balloon dilatation,1 case was catheter thrombosis suction ＋ stent.Artery embolisms were successfully opened in these 18 patients.After catheter thrombosis suction,small embolus embolized the distal vessels or thrombosis formed in the distal vessels in 4 cases,and after urokinase thrombolytic therapy,4 cases of distal vascular embolization was completely opened.Two cases of distal vascular embolization were partial opened,after thrombolysis the distal vascular still could not be opened,but collateral circulation was significantly increased.During a mean follow-up duration of 5.2 ± 5.3 months,lower limb ischemia symptoms in 15 patients were completely disappeared; foot skin temperature decreased in 2 patients; amputation was undergone in 1 case.Conclusion：Interventional treatment of lower limb arterial embolism is minimally invasive,simple and safe,it can reduce the risk of limb ischemia and necrosis.