AngioJet血栓清除装置在急性下肢深静脉血栓治疗中的应用

Percutaneous mechanical thrombectomy in the management of acute deep venous thrombosis of lower limb

目的:探讨AngioJet机械血栓清除装置在急性下肢深静脉血栓(DVT)治疗中的应用价值。方法:回顾性分析2016-01-2017-03我科收治的29例进行机械血栓清除术(PMT)的DVT患者,在临时性下腔静脉滤器保护下首先行PMT治疗,依据血管造影评价血栓清除率,对残存血管狭窄病变者予以成形治疗。出院后服用华法林或利伐沙班抗凝至少6个月,第1、3、6、12月返院复查下肢静脉彩超。结果:所有患者均行PMT治疗,术中DSA造影评估22例静脉血栓完全再通,达到清除率Ⅲ级,7例静脉血栓部分再通,达到清除率Ⅱ级。其中23例行狭窄髂静脉球囊扩张,21例行支架植入;所有患者无手术相关的严重并发症发生,随访期内1例患肢肿胀复发,行闭塞髂静脉支架植入后症状消失。其余患者无病变血管管腔血栓复发。结论:AngioJet机械血栓抽吸装置可迅速减轻血栓负荷,提高管腔完全再通率,在急性下肢深静脉血栓治疗中安全、有效,值得进一步推广应用。

Objective：To investigate the percutaneous AngioJet thrombectomy in the treatment of acute deep venous thrombosis（DVT）.Method：The clinical data of 29 patients with lower extremity DVT who were admitted to authors＇ hospital during the period from January 2016 to March 2017 were retrospectively analyzed.Percutaneous mechanical thrombectomy（PMT）by AngioJet TMwas performed.Those patients with Cockett syndrome underwent PTA and stent implantation.All patients continued to take Warfarin or Rivaroxaban at least six months after surgery.The patency rate of lower extremity deep venous was assessed by color Doppler Ultrasound at first,third,sixth and twelfth months after discharge.Result：All patients were treated with PMT.Angiography after the thrombectomy procedure showed 22patients＇ limbs fulfilled gradeⅢ while 7patients＇ limbs reached gradeⅡ criteria.A total of 23 patients who had Cockett syndrome underwent PTA and stent implantation.There was no major complications related to the procedure.One case suffered from limb swelling recurrence,and the symptom disappeared after stent implantation during the 6-month follow-up period.Conclusion：Percutaneous AngioJet thrombectomy provides a rapid removal of thrombus,and is safe and effective treatmentfor patients with acute lower extremity deep venous.