AngioJet机械性血栓抽吸装置在急性下肢动脉缺血中的应用

Application of Angiojet aspiration catheter in the treatment of acute lower extremity ischemia

目的总结Angio Jet机械性血栓抽吸装置在急性下肢动脉缺血中的应用经验。方法回顾性分析2017年2月至2018年1月因急性下肢缺血于本院住院治疗的患者共36例(患肢37条)的临床治疗,通过造影结果和术后患者症状的缓解情况来评估动脉的再通情况。随访包括症状的缓解程度、下肢动脉彩超以及踝肱比(ABI)。结果 36例患者均完成了吸栓/喷药-吸栓,吸栓术后行球囊扩张成形术者18例,支架植入者6例,所有患者术后即刻症状缓解明显,Angio Jet血栓抽吸技+球囊扩张/支架植入的技术成功率为94.4%(34/36)。随访32例经下肢动脉彩超及踝肱比(ABI)检查均超过3个月,27例经评估后下肢动脉通畅,5例出现部分缺血症状。结论 Angio Jet是一种将药物溶栓和机械吸栓相结合的清除下肢动脉血栓的非常有效的系统,具有微创、高效、简单、并发症少的优点,但是存在有一定的局限性,需要结合球囊扩张和支架植入进行补救性治疗,近期疗效满意,需要严格选择适应症,长期效果需要进一步的研究。

Objective To summarize the clinical experience in the treatment of acute lower extremity ischemia with Angio Jet Rheolytic Thrombectomy. Methods The clinical data of 36 patients（37 limbs）with acute lower extremity ischemia treated by Angiojet thrombus aspiration system from February 1, 2017 to January 31, 2018 were collected and analyzed. The patency of the artery is assessed by the results of intraoperative angiography and the relief of postoperative patients＇ symptoms. Follow up includes relief of symptoms, Doppler ultrasonic and ankle brachial ratio（ABI）. Results All 36 cases of patients, surgical technique success rate was 94.4%（34/36）, including 18 PTA cases and 6 PTAS cases after receiving spraying and thrombectomy. 32 cases were followed up for more than 3 months by color Doppler ultrasound and ankle brachial ratio（ABI）. The lower extremity artery was unobstructed in 27 cases and partial ischemic symptoms occurred in 5 cases. Conclusion Angio Jet is a combination of thrombolysis and mechanical aspiration of thrombus removal of arterial thrombosis and is very effective、minimally invasive、simple、effective、less complications, but there are certain limitations, requires a combination of balloon angioplasty and stent implantation for remedial treatment. The short-term effect is satisfactory, and the indications need to be selected strictly. The long-term effect needs further study.