Denck H
Acta Med Austriaca. 1976;3(4):135-7.
Indications for thrombectomy in acute thrombosis of the deep veins of the pelvis and lower extremities are: 1. Phlegmasia coerulea dolens with imminent danger of venous gangrene. 2. All cases: a) with contraindications for a therapy with fibrinolysis, b) after therapy-failures with thrombolytic therapy, c) thrombosis of more than 3 days duration. 3. In cases associated with tumours or trauma. If a thrombectomy can only be partially achieved, or in cases with an old thrombosis, a temporary arteriovenous fistula is performed. In cases with phlegmasia alba and the inexistence of danger for an extremity treatment with fibrinolysis, this is preferable in the first three days after onset, if general conditions permit this treatment. Results of venous thrombectomies are particularly astonishingly good in phlegmasia coerulea and it is therefore mandatory to transfer all fresh cases of thrombosis of the deep veins of the peelvis and lower extremities to an angiologic center in order to differentiate cases for fibrinolytic therapy, from those which require surgical intervention.
骨盆和下肢深静脉急性血栓形成时,血栓切除术的指征如下:1. 股青肿,有发生静脉坏疽的紧迫危险。2. 所有病例:a) 有纤维蛋白溶解疗法禁忌证者;b) 溶栓治疗失败后;c) 血栓形成超过3天者。3. 伴有肿瘤或创伤的病例。若血栓切除术只能部分完成,或为陈旧性血栓形成病例,则施行临时性动静脉瘘术。对于白肿且肢体无危险的病例,若一般情况允许进行纤维蛋白溶解治疗,则在发病后头三天内进行该治疗更为可取。静脉血栓切除术在股青肿病例中的效果特别惊人地好,因此必须将所有骨盆和下肢深静脉血栓形成的新病例转至血管病中心,以便区分需要纤维蛋白溶解治疗的病例和需要手术干预的病例。