Geschwind Jean-François H, Dagli Mandeep S, Lambert Drew L, Kobeiter Hicham
Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
J Endovasc Ther. 2003 Jun;10(3):590-4. doi: 10.1177/152660280301000327.
To evaluate the use of percutaneous transcatheter thrombolysis in the treatment of thrombosis due to radial artery cannulation.
Seven patients (4 women; age range 41-62 years) with symptomatic cannulation-induced thrombosis and failure to improve after systemic anticoagulation underwent 8 catheter-directed thrombolytic infusions at our institution over a 3-year period. Access was either antegrade through the brachial artery or retrograde through the femoral artery. Thrombolytic infusions with urokinase began 2 to 12 days (average 6) after removal of the radial artery catheter. The thrombolytic infusion was successful in 5 of 7 patients based on angiographic flow restoration with <20% residual thrombus and significant clinical improvement in the ischemia.
When systemic anticoagulation has failed, percutaneous catheter-directed thrombolytic infusion appears to be effective in the treatment of most patients with severe ischemic hand symptoms due to thrombosis after radial artery cannulation.
评估经皮经导管溶栓术在治疗桡动脉置管所致血栓形成中的应用。
7例（4例女性；年龄范围41 - 62岁）有症状的置管引起的血栓形成且全身抗凝治疗后未改善的患者，在3年期间于我院接受了8次导管定向溶栓输注。通路为经肱动脉顺行或经股动脉逆行。在拔除桡动脉导管后2至12天（平均6天）开始用尿激酶进行溶栓输注。基于血管造影显示血流恢复且残余血栓<20%以及缺血症状有显著临床改善，7例患者中有5例溶栓输注成功。
当全身抗凝治疗失败时，经皮导管定向溶栓输注似乎对大多数因桡动脉置管后血栓形成而出现严重手部缺血症状的患者有效。
