Schneider Darren B, Curry Thomas K, Eichler Charles M, Messina Louis M, Gordon Roy L, Kerlan Robert K
Division of Vascular Surgery, University of California San Francisco, California 94143, USA.
J Endovasc Ther. 2003 Apr;10(2):336-40. doi: 10.1177/152660280301000226.
To describe the successful use of percutaneous mechanical thrombectomy as an adjunct to thrombolysis for acute subclavian vein thrombosis due to venous thoracic outlet syndrome.
A 40-year-old man presented with arm swelling due to acute subclavian vein thrombosis and venous thoracic outlet syndrome. Percutaneous mechanical thrombectomy with the AngioJet device and thrombolysis were used to restore venous patency. Immediately following operative thoracic outlet decompression, the patient experienced rethrombosis, which was successfully treated using percutaneous mechanical thrombectomy. After 6 months, the patient remains symptom-free, with a patent subclavian vein by duplex ultrasonography.
Thrombus debulking or removal with percutaneous mechanical thrombectomy devices may reduce the amount or duration of thrombolytic therapy required, making treatment of venous thoracic outlet syndrome safer. Moreover, patients with recurrent thrombosis after thoracic outlet decompression may be safely treated with percutaneous mechanical thrombectomy, even when thrombolytic therapy is contraindicated.
描述经皮机械血栓切除术作为溶栓辅助手段治疗因胸廓出口综合征导致的急性锁骨下静脉血栓形成的成功应用。
一名40岁男性因急性锁骨下静脉血栓形成和胸廓出口综合征出现手臂肿胀。使用AngioJet装置进行经皮机械血栓切除术并结合溶栓治疗以恢复静脉通畅。在进行胸廓出口减压手术后，患者立即出现再血栓形成，经皮机械血栓切除术成功治疗了该情况。6个月后，患者无症状，经双功超声检查锁骨下静脉通畅。
使用经皮机械血栓切除装置减少血栓体积或清除血栓可减少所需溶栓治疗的量或持续时间，使胸廓出口综合征的治疗更安全。此外，即使溶栓治疗禁忌，胸廓出口减压术后复发性血栓形成的患者也可通过经皮机械血栓切除术得到安全治疗。
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