AngioJet机械血栓清除装置在急性下肢动脉缺血治疗中的应用

Rheolytic thrombectomy in the management of acute lower extremity arterial ischemia

目的探讨AngioJet机械血栓清除装置在急性下肢动脉缺血治疗中的应用价值。方法分析2016年1月—12月收治的5例急性下肢动脉缺血患者的临床资料,所有患者行DSA造影明确血栓部位及范围,术中应用AngioJet导管行机械性血栓抽吸,依据血管造影评价血栓清除率,术后辅以溶栓、抗凝及抗血小板聚集药物治疗,定期复查下肢动脉彩超。结果所有患者9个动脉闭塞部位经AngioJet机械血栓清除治疗,术中造影评估2处腘动脉血栓部分再通,清除率达到Ⅱ级,其余闭塞部位完全再通,清除率达到Ⅲ级。5例患者获随访时间2~13个月,平均(9.0±4.3)个月,随访期内1例出现间跛症状,无病变血管血栓复发,无截肢病例。结论 AngioJet机械血栓抽吸装置可快速清除血栓、恢复缺血肢体血供,在治疗动脉新鲜血栓形成所致下肢缺血中短期临床效果满意。

Objective:To investigate the percutaneous AngioJet thrombectomy in the treatment of acute limb ischemia(ALI).Methods:The clinical data of5patients with acute lower extremity ischemia(ALI)confirmed by DSA angiography,who later were treated by AngioJet thrombectomy in our hospital during January to December2016,were retrospectively analyzed.Percutaneous mechanical thrombectomy(PMT)by AngioJet was performed on all five patients followed by adjunctive pharmacotherapy.The patency rate of lower extremity artery was assessed by color Doppler Ultrasound at1and12months after discharge.Results:Nine arterial occlusion sites in all5patients were treated with PMT.Angiography after the thrombectomy procedure showed7limbs fulfilled gradeⅢwhile two sites reached gradeⅡcriteria.All patients were followed up for2to13months,with an average of(9.0±4.3)months.During the follow-up,one patient had recurrent intermittent claudication.There was no recurrence of the lower extremity arterial thrombosis,no death and limb amputation during the follow-up periods.Conclusions:Percutaneous AngioJet thrombectomy provides a rapid reperfusion to the ischemic extremity,and the short-term follow-up is satisfactory in the treatment of arterial fresh thrombosis.