Lonsdale R J, Berridge D C, Makin G S, Hopkinson B R, Wenham P W
Department of Vascular Surgery, University Hospital, Nottingham, UK.
J R Coll Surg Edinb. 1992 Feb;37(1):19-22.
Left heart thrombus has been regarded as a contraindication to thrombolysis. In this prospective study the role of echocardiography before thrombolysis in the cardiac assessment of 51 patients undergoing thrombolysis for a peripheral arterial occlusion was evaluated. Ten patients with positive echocardiograms were identified. Echocardiography contributed to the diagnosis of embolus in one patient. All eight patients with embolic arterial occlusions were successfully recanalized, comparing favourably with a success rate of 58% in patients with thrombotic occlusions. There were no embolic complications during thrombolytic treatment or in the subsequent 30 days. We conclude that thrombolysis can be performed safely despite the presence of left heart thrombus.
左心血栓一直被视为溶栓治疗的禁忌证。在这项前瞻性研究中，我们评估了超声心动图在51例因外周动脉闭塞接受溶栓治疗患者的心脏评估中，于溶栓前的作用。共识别出10例超声心动图检查结果呈阳性的患者。超声心动图有助于1例患者的栓子诊断。所有8例栓塞性动脉闭塞患者均成功实现血管再通，与血栓性闭塞患者58%的成功率相比更具优势。在溶栓治疗期间及随后30天内均未出现栓塞并发症。我们得出结论，即使存在左心血栓，溶栓治疗仍可安全进行。
