流变血栓清除术治疗急性下肢深静脉血栓形成

Rheolytic Thrombectomy for the Treatment of Acute Deep Vein Thrombosis of the Lower Extremity

目的 评价流变血栓清除术治疗急性下肢深静脉血栓形成的临床疗效与安全性。资料与方法 17例 1周内的急性下肢深静脉血栓形成患者 ,其中血栓形成位于髂静脉 1例 ,髂股静脉 4例 ,股静脉 6例 ,股静脉 5例 ,静脉 1例。血栓长度 4～ 3 0cm ,平均 11.2 9± 5 .86cm。采用经皮穿刺方法 ,置入 6F或 8FOasis流变溶栓导管并与高压注射器连接 ,将生理盐水以 2 .5ml/s的流率和 5 171kPa的压力注入 ,行流变血栓清除术 ,观察血管开通、临床疗效以及并发症发生情况。结果 流变血栓清除术后 ,17例重建了前向血流 ,并清除了绝大部分血栓物质 ,技术成功率 (残留狭窄 <5 0 % )为 10 0 %。 15及 3 0天的初始血管开通率均为 10 0 % ,无严重并发症发生。结论 流变血栓清除术能迅速、安全。

Objective To evaluate the efficacy and safety of hydrodynamic rheolytic thrombectomy for the treatment of acute deep vein thrombosis of the lower extremity.Materials and Methods With Seldinger technique and using F6 or F8 Oasis catheters, hydrodynamic rheolytic thrombectomy was performed in 17 patients with acute deep vein thrombosis of the lower extremity. The mean time of phlebothrombosis was 3.82±1.33 days and the mean thrombus length was 11.29±5.86cm. The Oasis catheter was connected with high-pressure injector and the saline was infused with 5171kPa at 2.5ml/s rate. Observation was focused on the revascularization, clinical efficacy and complications.Results After hydrodynamic rheolytic thrombectomy, most thrombus material was removed and antegrade blood flow was reestablished in all 17 cases. The technical successful rate, i.e. the residual luminal narrowing being less than 50%, was also 100%. The primary patent rate in both 15 and 30 days after the procedure was 100%. No serious complications occurred in all patients.Conclusion Hydrodynamic rheolytic thrombectomy can quickly, effectively and safely clear the acute thrombus in lower extremity.