O'Connor Paul, Lookstein Robert
Division of Interventional Radiology, The Mount Sinai Hospital, New York, NY.
Division of Interventional Radiology, The Mount Sinai Hospital, New York, NY.
Tech Vasc Interv Radiol. 2018 Jun;21(2):55-64. doi: 10.1053/j.tvir.2018.03.010. Epub 2018 Mar 15.
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, occur in up to 900,000 people per year in the United States. Current first-line therapy consists of systemic anticoagulation with a goal to prevent additional thrombus formation. Treatment with anticoagulation alone provides less than satisfactory results with some studies showing propagation of thrombus in almost 40% of cases. Current first-line therapy does not include active removal of thrombus and does little to alleviate acute symptoms and the damaging inflammatory response that may result in postthrombotic syndrome. As the public and clinicians continue to recognize the unmet need of venous disease, endovascular therapies, such as catheter-directed thrombolysis, mechanical thrombectomy, and pharmacomechanical catheter-directed thrombolysis, have been developed to provide minimally invasive therapy while minimizing complications. The article discusses the advantages and disadvantages of endovascular interventions for venous disease.
在美国，静脉血栓栓塞症，包括深静脉血栓形成和肺栓塞，每年发生在多达90万人身上。目前的一线治疗包括全身抗凝，目标是防止形成更多血栓。单独使用抗凝治疗的效果并不理想，一些研究表明，几乎40%的病例中血栓会继续发展。目前的一线治疗不包括积极清除血栓，对缓解急性症状以及可能导致血栓形成后综合征的破坏性炎症反应作用甚微。随着公众和临床医生不断认识到静脉疾病未得到满足的需求，已开发出血管内治疗方法，如导管直接溶栓、机械血栓切除术和药物机械导管直接溶栓，以提供微创治疗同时尽量减少并发症。本文讨论了静脉疾病血管内介入治疗的优缺点。
