滤器植入术后下腔静脉血栓形成的导管直接溶栓治疗
[Therapy of catheter-directed thrombolysis for inferior vena cava thrombosis after filter implantation].
作者信息
Lei Fengrui, Li Xiaoqiang, Qian Aimin, Yu Xiaobin, Rong Jianjie, Sang Hongfei, Meng Qingyou
机构信息
Department of Vascular Surgery, Second Affiliated Hospital, Soochow University, Suzhou 215004, China.
Department of Vascular Surgery, Second Affiliated Hospital, Soochow University, Suzhou 215004, China. Email:
出版信息
Zhonghua Yi Xue Za Zhi. 2014 Jul 22;94(28):2197-200.
OBJECTIVE
To evaluate the efficacy and safety of catheter-directed thrombolysis (CDT) in treating with inferior vena cava (IVC) thrombosis after filter implantation.
METHODS
A retrospective analysis of 13 patients with IVC thrombosis after filter implantation was conducted at our institution from June 2009 to June 2012. A total of 26 lower extremities were involved.IVC filters were implanted via right internal jugular vein. Then CDT was performed through small saphenous vein, popliteal vein or femoral vein. The dosage of urokinase was 0.6-1 million/day. The occlusive segment in IVC was managed with percutaneous transluminal angioplasty (PTA) and stenting.
RESULTS
The obstructed IVC was re-opened after CDT in 11 cases. The average CDT time was 8.3 (7-13) days. PTA (n = 2) and stenting (n = 1) were performed. A total of 4 retrievable filters were planted and retrieved later successfully.No severe complications occurred. During the follow-ups, no clinically detetable sighs of pulmonary embolism were observed.
CONCLUSION
CDT is effective, safe and feasible in the treatment of IVC thrombosis after filter implantation.
目的
评估导管定向溶栓（CDT）治疗滤器植入术后下腔静脉（IVC）血栓形成的有效性和安全性。
方法
对2009年6月至2012年6月在我院接受治疗的13例滤器植入术后IVC血栓形成患者进行回顾性分析。共累及26条下肢。IVC滤器经右颈内静脉植入。然后通过小隐静脉、腘静脉或股静脉进行CDT。尿激酶剂量为每日60万-100万单位。IVC闭塞段采用经皮腔内血管成形术（PTA）及支架置入术处理。
结果
11例患者经CDT后闭塞的IVC重新开通。CDT平均时间为8.3（7-13）天。进行了2例PTA及1例支架置入术。共植入4枚可回收滤器，随后均成功取出。未发生严重并发症。随访期间，未观察到临床可检测到的肺栓塞迹象。
结论
CDT治疗滤器植入术后IVC血栓形成有效、安全且可行。
Zotero 插件