Liu Feng-yong, Wang Mao-qiang, Duan Feng, Wang Zhi-jun, Song Peng, Wang Yan, Yan Jie-yu
Department of Interventional Radiology, The PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2012 May 22;92(19):1343-5.
To assess the efficacy and safety of interventional techniques in the treatment of deep venous thrombosis (DVT) and its complication of acute massive pulmonary thrombosis embolism (PTE).
Twenty massive PTE patients received the examinations of Doppler ultrasonography, computed tomography (CT) and venography. After a definite diagnosis, interventional therapy was used for symptomatic controls. The interventional procedures included catheter fragmentation and suction (n = 11), catheter-directed thrombolysis (n = 7), stent placement (n = 4) and inferior vena cava (IVC) filter placement (n = 11). After the above procedures, low doses of urokinase and heparin were prescribed for 1 week. During a follow-up period of 6 - 24 months, the findings of CT, radiography and ultrasound were re-examined.
Interventions were successful. The success rates of fragmentation and suction and iliac vein stenting were both 100%. No major complications occurred. Pulmonary embolism involved main trunks and branches of lungs. Both arterial blood pressure and oxygen saturation were below normal values. After interventions, the clinical symptoms and angiographic results improved obviously.
It is safe and effective to apply catheter-directed mechanical fragmentation, suction and thrombolysis in the treatment of DVT and PTE. IVC filter may be useful for the prevention of PTE.
评估介入技术治疗深静脉血栓形成（DVT）及其并发症急性大面积肺血栓栓塞症（PTE）的有效性和安全性。
20例大面积PTE患者接受了多普勒超声、计算机断层扫描（CT）和静脉造影检查。明确诊断后，采用介入治疗进行对症控制。介入操作包括导管碎栓及抽吸（n = 11）、导管直接溶栓（n = 7）、支架置入（n = 4）和下腔静脉（IVC）滤器置入（n = 11）。上述操作后，给予低剂量尿激酶和肝素治疗1周。在6至24个月的随访期内，复查CT、X线摄影和超声检查结果。
介入治疗成功。碎栓及抽吸和髂静脉支架置入的成功率均为100%。未发生重大并发症。肺栓塞累及肺的主干部位及分支。动脉血压和血氧饱和度均低于正常值。介入治疗后，临床症状和血管造影结果明显改善。
应用导管直接机械碎栓、抽吸和溶栓治疗DVT和PTE是安全有效的。IVC滤器可能有助于预防PTE。
