Tønnesen K H, Holstein P, Andersen E
Department of Clinical Physiology, Bispebjerg Hospital, Copenhagen, Denmark.
Eur J Vasc Surg. 1991 Aug;5(4):429-34. doi: 10.1016/s0950-821x(05)80176-8.
Removal of fibrin from the site of a newly dilated femoro-popliteal occlusion may be an attractive way of preventing rethrombosis. A double balloon catheter with a dilating tip balloon and an occlusive balloon 10, 15 or 20 cm approximately were introduced percutaneously. Following successful dilatation of femoro-popliteal occlusions, the balloons were inflated on both sides of the lesion. The dilated segment was then isolated from the circulation. Through a sideport between the balloons 5 mg of tissue type plasminogen activator and 1000 IU of heparin were installed within the segment for 30 min. The authors report the results of 53 technically successful dilatations of femoro-popliteal occlusions followed by enclosed thrombolysis. A 100% patency at 3 months was noted in 33 patients having one to three run-off arteries, and the one year patency was 90%. In 20 patients, with no infrapopliteal run-off artery, four rethrombosis occurred within 24 h, and the one year patency was 62%. This difference is significant. (Log rank test, Chi-square = 4.73, p less than 0.05). We conclude that enclosed thrombolysis prevents early reocclusion following PTA of femoro-popliteal occlusions provided that at least one infra-popliteal artery is patent.
从新扩张的股腘动脉闭塞部位清除纤维蛋白可能是预防再血栓形成的一种有效方法。经皮插入一根双球囊导管，其扩张头球囊和闭塞球囊的长度分别约为10、15或20厘米。成功扩张股腘动脉闭塞后，在病变两侧充盈球囊。然后将扩张段与循环系统隔离。通过球囊之间的侧孔，将5毫克组织型纤溶酶原激活剂和1000国际单位肝素注入该段血管内并保持30分钟。作者报告了53例技术上成功的股腘动脉闭塞扩张术并随后进行封闭溶栓的结果。在有一至三条流出道动脉的33例患者中，3个月时的通畅率为100%，一年通畅率为90%。在20例没有腘下流出道动脉的患者中，24小时内发生了4例再血栓形成，一年通畅率为62%。这种差异具有统计学意义（对数秩检验，卡方 = 4.73，p < 0.05）。我们得出结论，只要至少有一条腘下动脉通畅，封闭溶栓可预防股腘动脉闭塞经皮腔内血管成形术后的早期再闭塞。
