同期血栓机械清除联合髂静脉支架植入治疗急性下肢深静脉血栓形成12例

发布时间：2018-05-13 14:15

  本文选题：髂静脉受压综合征 + 深静脉血栓形成　； 参考：《介入放射学杂志》2017年01期

【摘要】：目的评价经皮机械血栓清除术(PMT)联合髂静脉支架植入一期治疗急性下肢深静脉血栓形成(DVT)的可行性、安全性及有效性。方法 2014年12月至2016年1月收治12例急性下肢DVT伴左侧髂静脉受压综合征(IVCS)患者,男3例,女9例,平均年龄(50.42±16.21)岁;均有左下肢肿胀、疼痛症状,其中中央型3例,混合型9例。所有患者术前均置入下腔静脉滤器,术后取出。Angio Jet血栓清除导管PMT术、球囊扩张和髂静脉支架植入均在同期完成,复查造影有残余血栓时保留鞘管,给予溶栓治疗。术后1、3、6、12个月门诊随访,彩色超声和(或)下肢静脉造影复查了解深静脉及支架内血流通畅情况。结果 12例患者均同期完成手术,技术成功率100%。手术时间60~110 min,平均(96.25±14.32)min;血栓抽吸时间51~280 s,平均(199.92±74.89)s。血栓清除率Ⅲ级10例,Ⅱ级2例,临床症状均得到缓解。除部分患者在左髂总静脉球囊扩张中有不同程度疼痛外,无肺栓塞、严重出血等并发症发生。平均随访(5.58±2.75)个月,11例彩色超声和(或)下肢静脉造影提示深静脉及髂静脉支架内血流通畅,1例脑星形细胞瘤手术患者复发。结论同期PMT联合髂静脉支架植入治疗急性下肢DVT方法安全可行,初步临床疗效满意。
[Abstract]:Objective to evaluate the feasibility, safety and efficacy of percutaneous mechanical thrombus removal (PMT) combined with iliac vein stent implantation in the treatment of acute deep venous thrombosis of the lower extremity (DVT). Methods from December 2014 to January 2016, 12 patients (male 3, female 9, mean age 50.42 卤16.21) with acute lower extremity DVT with left iliac vein compression syndrome were treated. Mixed type 9 cases. All the patients were implanted with inferior vena cava filter before operation. PMT was removed after operation. Balloon dilation and stent implantation of iliac vein were performed simultaneously. The sheath tube was retained in the case of residual thrombus in contrast examination and thrombolytic therapy was given. The blood flow in deep vein and stent was evaluated by color ultrasound and / or lower extremity venography. Results all the 12 patients completed the operation at the same time, and the technical success rate was 100%. The operative time was 60 ~ 110 min, the average time was 96.25 卤14.32 min, the time of thrombus aspiration was 51 ~ 280 s, the average time was 199.92 卤74.89 s. The clearance rate of thrombus was 10 cases in grade 鈪，

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