下肢动脉闭塞介入中发生远端栓塞的治疗经验

Therapy experience of distal embolization occurred during interventional therapy of lower extremities artery occlusion

目的分析下肢动脉闭塞介入治疗(IT)中发生远端动脉栓塞(DE)的资料,总结其规律及处理措施。方法回顾性分析山西省人民医院血管外科自2011年10月至2014年5月部分因下肢动脉闭塞而行IT患者126例的临床资料。其中6例患者出现DE,3例给予动脉内置管溶栓,2例行动脉切开取栓,1例仅给予观察。结果 6例DE术后无静息痛、坏疽等出现,均获得随访,随访中没有发现DE对患者的近、中远期效果造成不良影响。结论介入前仔细阅片、介入中仔细操作可以有效地降低DE的发生率;出现DE后根据不同的栓塞部位及临床表现,采用积极、正确的处理措施可以最大限度地降低其危害。

Objective To analyze the data of distal embolization（ DE） occurred during interventional therapy（ IT） of lower extremities artery occlusion,and summarize its rules and treatment. Methods One hundred and twenty six patients with lower extremities artery occlusion who were performed IT were included from October 2011 to May 2014 in Shanxi Provincial Peoples Hospital. DE occurred in six patients; three of whom received catheter-directed thrombolysis,two received thrombectomy and one received observation. Results The six patients had no serious consequence and acquired follow-up. During follow-up,DE didnt cause the adverse impact on the early,middle and later therapy effect.Conclusion Careful film reading before IT and careful manipulation during IT can reduce the incidence of DE. If DE happens,the correct and positive treatment can minimize its harmfulness according to the embolism location and clinical presentation.