AngioJet机械性血栓清除装置在下肢深静脉血栓中的应用32例

AngioJet mechanical thrombectomy system in 32 cases of lower extremity deep venous thrombosis

目的总结AngioJet机械性血栓清除装置在下肢深静脉血栓的应用。方法回顾性分析2017年1月至2017年12月因下肢深静脉血栓于复兴医院住院手术治疗的32例患者的临床资料,通过术中造影结果、术后患者症状的缓解情况,术后患肢的腿围变化来评估下肢静脉的再通情况。随访包括症状的缓解程度、下肢静脉彩超来评估吸栓后血管的通畅程度。结果 32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19例,12例行支架植入,所有患者术后即刻症状缓解明显。AngioJet血栓抽吸术联合球囊扩张支架植入术的技术成功率为100%(32/32),患肢腿围由术前(49±0.4)cm下降至术后(38±0.6)cm(P<0.05)。平均手术时间(1.2±0.3)小时,尿激酶平均剂量(16.1±2.2)万U。术后随访所有患者经下肢静脉彩超及下肢腿围检查均超过3个月,经评估后下肢静脉通畅。结论 AngioJet是一种将药物溶栓和机械吸栓相结合的清除下肢深静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,但是存在一定的局限性,需要结合球囊扩张作为补充治疗,近期疗效满意,但是需要严格选择适应证,长期效果需要进一步的研究。

Objective To summarize 32 cases experience in the treatment of lower extremity deep venous thrombosis with AngioJet Rheolytic Thrombectomy.Methods The clinical data of 32 patients with lower extremity deep venous thrombosis treated by Angiojet thrombus aspiration system from January 2017 to December 2017 were collected and analyzed.The patency of the vein is assessed by intraoperative angiography and the relief of postoperative patients'symptoms,and shrinkage in leg circumference.The relief of symptoms and the venous patency was evaluated by Doppler ultrasonography during follow up.Results Technical success rate was 100%(32/32).Nineteen cases accepted PTA after receiving spraying and thrombectomy,12 cases accepted stent implantation,all the patients were totally relieved after intervention.Leg circumference decreased from(49±0.4)cm to(38±0.6)cm(P<0.05),average operation time was(1.2±0.3)hs and average urokinase dosage was(161±22)thousand Units.All cases were followed up for more than 3 months by color Doppler ultrasonography and limb circumference measurement.All treated veins remained patent.Conclusions AngioJet,is a very effective system which combines thrombolysis and mechanical aspiration for the removal of deep venous thrombus.It has advantaged of effective,minimally invasive,simple,and less complications.However,AngioJet thrombectomy requires combination of balloon or stent angioplasty.The short-term clinical result is satisfactory,and the indications should to be strictly controlled.The long-term clinical results requires further study.