Rotarex机械血栓清除系统治疗累及膝下腘动脉血栓栓塞病变的疗效观察

Efficacy of Rotarex mechanical thrombectomy system for thromboembolic lesions involving infraknee popliteal artery

目的 评估Rotarex机械血栓清除系统治疗累及膝下腘动脉的血栓栓塞病变的有效性及安全性。方法 回顾性分析2019年9月至2022年2月采用Rotarex机械血栓清除系统治疗的累及膝下腘动脉血栓栓塞患者13例,其中栓塞病变8例,血栓形成5例。按急性下肢缺血分级:Ⅰ级6例,Ⅱa级5例,Ⅱb级2例。观察术中血栓清除技术成功率、血管穿孔破裂、远端栓塞、术后30 d并发症和靶血管通畅率以及再干预率等。结果 本组手术技术成功率为100%,均一期清除血栓。术中无动脉穿孔破裂,3例患者发生远端栓塞,使用MPA导管抽吸后血流恢复通畅,4例患者术中行补救性支架植入,术后30 d心肌梗死1例,无死亡及截肢。平均随访(14.7±5.3)个月,4例发生有临床症状的靶血管再狭窄,2例再次行腔内治疗后症状缓解。结论 对于下肢动脉血栓栓塞患者,包括累及膝下腘动脉者,使用Rotarex系统行机械血栓清除安全有效。

Objective To evaluate the effect and safety of Rotarex mechanical thrombectomy system in the treatment of thromboembolic lesions involving infraknee popliteal artery.Methods A total of 13 patients suffered thromboembolism involving infraknee popliteal artery treated with Rotarex mechanical thrombectomy system from September 2019 to February 2022 were analyzed retrospectively,including 8 of thromboembolism and 5 of thrombosis.There were 6 cases of gradeⅠ,5 cases of gradeⅡa and 2 cases of gradeⅡb according to the classification of acute lower limb ischemia.The technical success rate of thrombectomy,vascular perforation and rupture,distal embolization,complications within 30 days after the operation,patency rate of target vessels and re-intervention rate were observed.Results The technical success rate of the operation was 100%.There was no arterial perforation and rupture during the operation.Distal embolization occurred in 3 patients and treated by suction with MPA catheter successfully.4 patients underwent bailout stent during the operation,and there were no complications of amputation and death 30 days thereafter.The average follow-up was 14.7±5.3 months.Target vessel restenosis with clinical symptoms occurred in 4 patients,and 2 of them received re-intervention and relieved.Conclusion Percutaneous mechanical thrombectomy with Rotarex system is safe and effective for patients with lower limb arterial thromboembolism involving infraknee popliteal artery.