Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, 920 S L Young Boulevard, Oklahoma City, OK 73190, USA.
Angiology. 2012 Feb;63(2):138-45. doi: 10.1177/0003319711410050. Epub 2011 May 20.
Pharmacomechanical thrombolysis (PMT) is an emerging treatment option for symptomatic deep vein thrombosis (DVT). This may obviate the need for systemic or catheter-directed thrombolysis. PubMed, EMBASE, and Cochrane database search of PMT in acute and chronic symptomatic DVT was undertaken. Baseline demographic and clinical characteristics, procedural details, DVT characteristics, and procedural and clinical outcomes are presented. A total of 8 case series (n = 2528; 1998-2009) qualified for inclusion. Lower extremity symptomatic DVTs constituted the majority of the cases (>80%). Both acute (<14 days) and chronic (>14 days) DVTs were included. Procedural success was 59% to 100% and catheter-directed thrombolysis was used as an adjunct in 16% to 53%. No deaths or major bleeding complications were reported. Pharmacomechanical thrombolysis leads to the immediate resolution of clinical symptoms of DVT in the majority of patients. Pharmacomechanical thrombolysis may be a safe and novel method, when appropriate expertise and resources are available, for the treatment of symptomatic acute and chronic DVT.
药物机械溶栓 (PMT) 是一种新兴的治疗有症状的深静脉血栓形成 (DVT) 的方法。这可能避免了全身或导管定向溶栓的需要。在 PubMed、EMBASE 和 Cochrane 数据库中对急性和慢性有症状的 DVT 的 PMT 进行了搜索。呈现了基线人口统计学和临床特征、程序细节、DVT 特征以及程序和临床结果。共有 8 项病例系列研究 (n = 2528; 1998-2009) 符合纳入标准。下肢有症状的 DVT 占大多数 (>80%)。包括急性 (<14 天) 和慢性 (>14 天) DVT。程序成功率为 59% 至 100%，16% 至 53% 使用了导管定向溶栓作为辅助治疗。没有死亡或主要出血并发症的报告。在大多数患者中，药物机械溶栓可立即缓解 DVT 的临床症状。当有适当的专业知识和资源时，药物机械溶栓可能是一种安全且新颖的治疗有症状的急性和慢性 DVT 的方法。
