Kim Byung Joon, Chung Hwan Hoon, Lee Seung Hwa, Je Bo Kyung, Lee Young Heon, Seo Bo Kyoung, Kim Baek Hyun, Cha Sang Hoon
Department of Radiology, Ansan Hospital, Korea University College of Medicine, Seoul, Korea.
Acta Radiol. 2010 Apr;51(3):248-55. doi: 10.3109/02841850903536078.
The risk of complications and discomfort in patients who undergo prolonged infusion of a thrombolytic agent is significant when conventional catheter-directed thrombolysis is used to treat lower extremity deep vein thrombosis (DVT).
To evaluate the feasibility and safety of single-session endovascular treatment for symptomatic lower extremity DVT.
Single-session endovascular treatment for lower extremity DVT was performed on 29 limbs in 26 patients diagnosed with acute DVT in our institution. Nine patients were male and 17 female, with a mean age of 64 years (range 28-82 years). At 5-10 min after the locoregional injection of the thrombolytic agent (urokinase) via a 5-Fr catheter to soften the thrombus, aspiration thrombectomy was performed with a large-bore sheath. In patients with an underlying anatomical stenosis or obstruction, combined angioplasty with or without stent placement was performed immediately after the complete removal of the thrombus. We then evaluated the technical and clinical outcomes of the procedure, along with any complications or recurrences of DVT.
Technical success was achieved in 24 procedures (82.8%) of single-session endovascular treatment for lower extremity DVT, and clinical success was achieved in 22 (75.9%) of these single-session procedures. Additional catheter-directed thrombolysis procedures were performed on five limbs after repeated aspiration thrombectomies failed to completely remove thrombi in those limbs. Stenotic or occlusive lesions were revealed in 24 limbs and percutaneous angioplasty procedures with or without stent placement were performed in these cases. No major complications resulted from the procedure.
Single-session endovascular treatment is a feasible technique that provides acceptable technical and clinical success with excellent safety for treating symptomatic lower extremity DVT.
在使用传统导管直接溶栓治疗下肢深静脉血栓形成（DVT）时，接受长时间溶栓药物输注的患者出现并发症和不适的风险很大。
评估单期血管内治疗有症状下肢DVT的可行性和安全性。
在我们机构中，对26例诊断为急性DVT的患者的29条肢体进行了单期血管内治疗下肢DVT。9例为男性，17例为女性，平均年龄64岁（范围28 - 82岁）。通过5F导管局部注射溶栓药物（尿激酶）5 - 10分钟以使血栓软化后，用大口径鞘管进行抽吸血栓切除术。对于存在潜在解剖学狭窄或阻塞的患者，在血栓完全清除后立即进行联合血管成形术，可选择放置或不放置支架。然后我们评估了该手术的技术和临床结果，以及DVT的任何并发症或复发情况。
下肢DVT单期血管内治疗的24例手术（82.8%）取得技术成功，其中22例（75.9%）取得临床成功。在5条肢体经反复抽吸血栓切除术未能完全清除血栓后，进行了额外的导管直接溶栓手术。24条肢体发现有狭窄或闭塞性病变，对这些病例进行了有或无支架置入的经皮血管成形术。该手术未导致重大并发症。
单期血管内治疗是一种可行的技术，在治疗有症状下肢DVT时具有可接受的技术和临床成功率，且安全性良好。
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