Stelzner C, Langhoff R
Abteilung für Angiologie, Medizinische Klinik 2, Städtisches Klinikum Dresden-Friedrichstadt, Akademisches Lehrkrankenhaus, Technische Universität Dresden, Friedrichstr. 41, 01067, Dresden.
Internist (Berl). 2011 Nov;52(11):1276, 1278-80, 1282-3. doi: 10.1007/s00108-011-2867-7.
Local catheter-directed thrombolysis of extremity artery or bypass thromboembolic occlusions is a promising therapeutic option with comparatively low complication rates, if the severity of the ischemia does not require urgent surgical revascularization. This therapeutic decision has to be made by a vascular team taking individual circumstances and contraindications into consideration. Apart from an adequate dosage, a strict intrathrombotic administration of the fibrinolytic agent and careful clinical monitoring including surveillance of the coagulation system is necessary and intensive care unit resources should be used. If necessary the thrombolysis therapy can be combined with mechanical thrombaspiration and balloon dilatation or surgical correction of an underlying lesion.
对于肢体动脉或旁路血栓栓塞性闭塞症，若缺血程度无需紧急手术血运重建，局部导管定向溶栓是一种很有前景的治疗选择，其并发症发生率相对较低。这一治疗决策必须由血管团队在考虑个体情况和禁忌证后做出。除了适当的剂量外，还必须严格将纤溶药物进行血栓内给药，并进行仔细的临床监测，包括对凝血系统的监测，且应使用重症监护病房的资源。如有必要，溶栓治疗可与机械血栓抽吸、球囊扩张或对潜在病变进行手术矫正相结合。
