超声消融治疗慢性下肢深静脉血栓形成

Ultrasonic Ablation in Chronic Deep Vein Thrombosis of Lower Extremity

目的评价静脉超声消融在治疗慢性下肢深静脉血栓形成中的作用。方法 38例慢性深静脉血栓患者接受了静脉内超声消融治疗,超声消融时间为12～24分钟,平均18分钟,术后应用肝素抗凝,应用静脉趋动器促进血液回流。结果 38例髂股静脉闭塞中31例完全再通,再通达81％,7例部分再通,部分再通达19％。31例完全再通者随访24例,15例未安放支架者,10例发生再闭塞,达65％,9例安放支架者2例发生再闭塞,再闭塞22％。结论超声消融可以再通已经闭塞的髂股静脉并为进一步进行球囊扩张和安放内支架创造了条件。

Objective To evaluate the clinical efficiency of ultrasonic ablation in patients with chronic deep vein thrombosis of lower extremity. Methods 38 patients of chronic deepvein hrombosis with total occlusion in left ilio- femoral vein Through the surgical approach ultrasonic ablation catheter was inserted into occluded ilio - femoral vein segment.The ultrasonic ablation device consists of a 2.2mm diameter flexible wire attached to a piezoelectric crystal generating ultrasound at 24KHz The time of ultrasonic ablation was 12-24 minutes. Result Ultrasonic ablation easily created a channel within the occlusive ilio- femoral vein and achieved successful recanalization in 31 of 38 patients.Follow- up showed that there were 2 cases of recolusion in 9 paatients with stont insert and 10 of 15 patients without stent suffered from reocclusion. Conclusion The results suggest that intravascular ultrasonic ablation is effective thrapeautic modality for patients with chronic ilio - femoral vein acclusion and additional endovascular treatment modalities are necessary to obtain a goodclinical result.