Jørgensen B, Tønnesen K H, Nielsen J D, Holstein P, Bülow J, Jørgensen M, Andersen E
Department of Clinical Physiology/Nuclear Medicine, Bispebjerg Hospital, University of Copenhagen, Denmark.
Cardiovasc Intervent Radiol. 1991 Sep-Oct;14(5):293-8. doi: 10.1007/BF02578453.
Segmentally enclosed thrombolysis (SET) was performed immediately following 34 percutaneous transluminal angioplasties (PTAs) for femoropopliteal occlusions. The dilated segment was sealed off with a double balloon catheter, and recombinant tissue plasminogen activator (rt-PA) 1 mg/ml and heparin 200 IU/ml were injected between the balloons. The catheter was removed after 30 min and heparin treatment was continued for 24 h. Alpha-2-antiplasmin was initially reduced by 13% and normalized 2 h after SET, indicating that only small amounts of free plasmin were liberated during thrombolysis. No clinically relevant changes in plasma fibrinogen occurred. Two puncture site hemorrhages did not coincide with the coagulopathy induced by SET. One-year patency was 80%. Early rethrombosis occurred in 9% versus 41% in our previous series on standard PTA for femoropopliteal occlusions (p less than 0.001). Therefore, SET is considered beneficial in reducing the incidence of early rethrombosis.
对34例股腘动脉闭塞患者进行经皮腔内血管成形术（PTA）后，立即进行节段性封闭溶栓（SET）。用双球囊导管封闭扩张段，并在球囊之间注入1mg/ml的重组组织型纤溶酶原激活剂（rt-PA）和200IU/ml的肝素。30分钟后取出导管，并继续肝素治疗24小时。α-2-抗纤溶酶最初降低了13%，SET后2小时恢复正常，表明溶栓过程中仅释放了少量游离纤溶酶。血浆纤维蛋白原未发生临床相关变化。两个穿刺部位出血与SET引起的凝血病无关。一年通畅率为80%。早期再血栓形成发生率为9%，而我们之前关于股腘动脉闭塞标准PTA的系列研究中为41%（p<0.001）。因此，SET被认为有利于降低早期再血栓形成的发生率。
