Arko Frank R, Cipriano Paul, Lee Eugene, Filis Konstantinos A, Zarins Christopher K, Fogarty Thomas J
Division of Vascular Surgery, Stanford University Medical Center, Stanford University, Stanford, California 94305, USA.
J Endovasc Ther. 2003 Aug;10(4):733-8. doi: 10.1177/152660280301000408.
To report successful combined percutaneous mechanical thrombectomy and pharmacological lysis for axillosubclavian vein thrombosis, with rapid clot removal at a single setting using low-dose thrombolysis.
Two consecutive patients presented with arm swelling; the diagnosis of axillosubclavian vein thrombosis was confirmed with duplex ultrasound. Both patients were treated percutaneously with the Solera mechanical thrombectomy device, after which 5 mg of tissue plasminogen activator were delivered within approximately 10 minutes via the Trellis infusion catheter to remove any residual thrombus. Completion venography and serial duplex ultrasound scans in follow-up demonstrated widely patent axillosubclavian veins with no residual thrombus in both cases.
Standard treatment of axillosubclavian vein thrombosis may require 12 to 36 hours, with multiple trips to the angiography suite. The novel technique combining mechanical thrombectomy and pharmacological lysis can be performed safely and successfully at a single setting with a small dose of the lytic drug.
报告经皮机械血栓切除术与药物溶栓联合治疗腋-锁骨下静脉血栓形成的成功案例，该方法使用低剂量溶栓剂在单次治疗中快速清除血栓。
连续两名患者出现手臂肿胀；经双功超声证实为腋-锁骨下静脉血栓形成。两名患者均使用索莱拉机械血栓切除术装置进行了经皮治疗，之后通过Trellis输注导管在约10分钟内注入5毫克组织纤溶酶原激活剂，以清除任何残留血栓。随访中的静脉造影完成情况及系列双功超声扫描显示，两例患者的腋-锁骨下静脉均广泛通畅，无残留血栓。
腋-锁骨下静脉血栓形成的标准治疗可能需要12至36小时，且需多次前往血管造影室。机械血栓切除术与药物溶栓相结合的新技术可在单次治疗中安全、成功地使用小剂量溶栓药物完成。
