Zehnder T, Birrer M, Do D D, Baumgartner I, Triller J, Nachbur B, Mahler F
Division of Angiology, University Hospital Bern, Switzerland.
Eur J Vasc Endovasc Surg. 2000 Jul;20(1):41-6. doi: 10.1053/ejvs.2000.1117.
To evaluate the role of a combined percutaneous endovascular approach including thrombus aspiration, catheter thrombolysis, and percutaneous transluminal angioplasty (PTA) to treat acute and subacute occlusions of native leg arteries.
Retrospective evaluation of the effectiveness and safety of this catheter therapy in 89 consecutive patients (93 legs) in a single centre.
Treatment was initially successful in 90% of legs. Mortality at 30 days was 8%, and at 12 months 19%. Amputation-free survival at 12 months was 78%. Aspiration alone was sufficient in 31% of cases, urokinase (mean dose 112 500+/-55 900 IU) was used in 22%, PTA was added in 69%. There was no major bleeding except for one false aneurysm treated by ultrasound-guided compression. Secondary interventions within 12 months were required in 30% of cases (14 endovascular, 16 open surgical procedures).
Catheter thrombus aspiration in combination with thrombolysis and/or PTA is highly effective. Only in a minority of patients are thrombolytics in modest doses necessary, and serious bleeding complications are rare. We recommend this procedure as first-line treatment for acute or subacute infrainguinal arterial occlusions.
评估经皮血管腔内联合治疗方法（包括血栓抽吸、导管溶栓及经皮腔内血管成形术（PTA））在治疗下肢动脉原位急性和亚急性闭塞中的作用。
对单中心连续89例患者（93条腿）采用该导管治疗方法的有效性和安全性进行回顾性评估。
初始治疗成功率为90%。30天死亡率为8%，12个月死亡率为19%。12个月时无截肢生存率为78%。31%的病例单纯抽吸即可，22%的病例使用了尿激酶（平均剂量112500±55900IU），69%的病例加用了PTA。除1例假性动脉瘤经超声引导压迫治疗外，无严重出血发生。30%的病例在12个月内需要二次干预（14例血管腔内干预，16例开放手术）。
导管血栓抽吸联合溶栓和/或PTA非常有效。仅少数患者需要小剂量溶栓药物，严重出血并发症罕见。我们推荐将该方法作为急性或亚急性股腘动脉闭塞的一线治疗方法。
