AngioJet机械血栓清除在急性肠系膜上动脉栓塞治疗中的应用价值

Application value of AngioJet mechanical thrombectomy device in treating acute superior mesenteric artery embolism

目的探讨AngioJet机械血栓清除装置治疗急性肠系膜上动脉栓塞(ASMAE)的临床效果。方法回顾性分析2019年2月至2020年3月单中心采用AngioJet机械血栓清除装置治疗的7例ASMAE患者临床资料。观察评价临床疗效和手术相关并发症。结果7例术中血管造影均显示肠系膜上动脉(SMA)主干闭塞,其中1例伴空肠动脉栓塞。5例完全取栓,2例部分取栓,其中1例伴空肠动脉栓塞结合导管接触溶栓(CDT)治疗3 d后血栓完全清除,1例SMA主干残留附壁血栓结合球囊扩张后狭窄解除。1例术后5 d因多脏器衰竭死亡,2例术后出现血红蛋白尿,其余患者未出现手术相关并发症。6例随访3~12个月,无腹痛、腹胀发生。结论AngioJet机械血栓清除治疗ASMAE微创、安全有效,可作为ASMAE一种替代性血管内治疗方法。

Objective To investigate the clinical effect of AngioJet mechanical thrombectomy device in treating acute superior mesenteric artery embolism(ASMAE).Methods The clinical data of 7 patients with ASMAE,who received AngioJet mechanical thrombectomy in single center during the period from February 2019 to March 2020,were retrospectively analyzed.The clinical efficacy and procedure-related complications were evaluated.Results Intraoperative angiography showed that occlusion of superior mesenteric artery(SMA)trunk was detected in all 7 patients,including one patient with coexisting jejunal artery embolism.Complete thrombectomy was achieved in 5 patients and partial thrombectomy was obtained in 2 patients,among the two patients one patient with coexisting jejunal artery embolism obtained complete thrombectomy after receiving additional catheter-directed thrombolysis(CDT)for 3 days and in another patient the stenosis due to residual mural thrombus in the main trunk of SMA was improved after balloon dilatation.One patient died of multipleorgan failure five days after the treatment,2 patients developed hemoglobinuria,and no procedure-related complications occurred in other patients.Six patients were followed up for 3-12 months,and no abdominal pain or distension occurred.Conclusion For the treatment of ASMAE,AngioJet mechanical thrombectomy is minimally-invasive,safe and effective.It can be used as an alternative endovascular therapy for ASMAE.