Dorros G, Jamnadas P, Lewin R F, Sachdev N
Department of Cardiology, St. Luke's Medical Center, Milwaukee.
Cathet Cardiovasc Diagn. 1989 Aug;17(4):202-6. doi: 10.1002/ccd.1810170404.
Percutaneous aspiration of a thromboembolus was successfully performed in 12 out of 13 patients with in situ thrombosis (4 patients), distal embolization (7 patients), or both (2 patients). The flow was improved from TIMI 0 (10 patients, no flow) or TIMI 1 (2 patients, impaired flow) to TIMI 3 (10 patients, normal flow) or TIMI 2 (2 patients, normal but slower flow). A custom-made 8 F Teflon-coated sheath was introduced in the superficial femoral and proximal below-the-knee arteries to aspirate the debris. Distal embolization in below-the-knee arteries was concomitantly treated with short-term intraarterial Urokinase in nine patients. Complications included one in-hospital (not procedure related) death, two patients with below-the-knee amputations (above-the-knee amputation averted), and one transmetatarsal amputation (prior established gangrene present and below-the-knee amputation avoided). The remaining nine patients left the hospital with improved limb status and peripheral pulses. This technique is a rapid, reliable, and efficient method to treat in-situ clot or procedure-related distal embolization as an adjuvant or complement to lytic treatment.
13例原位血栓形成（4例）、远端栓塞（7例）或两者皆有（2例）的患者中，12例成功进行了经皮血栓切除术。血流从TIMI 0级（10例，无血流）或TIMI 1级（2例，血流受损）改善为TIMI 3级（10例，血流正常）或TIMI 2级（2例，血流正常但较慢）。在股浅动脉和膝下动脉近端引入定制的8F聚四氟乙烯涂层鞘以抽吸碎片。9例患者的膝下动脉远端栓塞同时接受了短期动脉内尿激酶治疗。并发症包括1例院内死亡（与手术无关）、2例膝下截肢（避免了膝上截肢）和1例经跖骨截肢（术前存在坏疽，避免了膝下截肢）。其余9例患者出院时肢体状况和外周脉搏均有所改善。该技术是一种快速、可靠且有效的方法，可作为溶栓治疗的辅助或补充手段，用于治疗原位血栓或与手术相关的远端栓塞。
