对侧股静脉入路经皮机械吸栓结合导管接触溶栓治疗急性下肢深静脉血栓形成的效果

Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity via contralateral femoral vein approach

目的·分析经对侧股静脉入路行经皮机械吸栓(percutaneous mechanical thrombectomy, PMT)结合导管接触溶栓(catheter-directed thrombolysis,CDT)治疗全肢型急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的早期临床效果。方法·回顾性分析从2016年9月至2017年8月接受AngioJet血栓抽吸+CDT治疗的45例患者的技术成功率、不同静脉段的血栓溶解程度及治疗过程中并发症的发生情况。结果·技术成功率为100%。其中,86.7%的患者下肢静脉血栓(lower extremity thrombosis,LET)Ⅰ段(小腿静脉)完全溶解,82.2%的患者LETⅡ段(股腘静脉)完全溶解,71.1%的患者LETⅢ段(髂股总静脉)完全溶解。无严重并发症发生。结论·对急性下肢DVT采用PMT+CDT是可行的、安全的、有效的。

Objective·To analyze the early clinical effects of acute deep venous thrombosis(DVT)of the lower extremities through a contralateral femoral vein approach by percutaneous mechanical thrombectomy(PMT)combined with catheter-directed thrombolysis(CDT)therapy.Methods·A retrospective analysis about 45 patients(from September 2016 to August 2017)was conducted to analyze the success rate of the technique,the degree of thrombolysis in different venous segments,and the incidence of complications during the treatment of PMT+CDT.Results·Technique successful rate was 100%.86.7%of lower extremity thrombosis(LET)Ⅰsegments(calf veins),82.2%of LETⅡsegments(femoral and popliteal veins)and 71.1%of LETⅢsegments(common iliac and femoral veins)were completely dissolved.No serious complications occurred.Conclusion·It is feasible,safe and effective to use PMT+CDT in acute DVT.