Cournoyer-Rodrigue Jean, Bui The-Bao, Gilbert Patrick, Soulez Gilles, Perreault Pierre, Bouchard Louis, Oliva Vincent L, Giroux Marie-France, Therasse Eric
Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Department of Radiology, Centre Hospitalier de l'Université de Sherbrooke, Hôpital Fleurimont (CHUS), Sherbrooke, Québec, Canada.
J Vasc Interv Radiol. 2020 Mar;31(3):444-453.e2. doi: 10.1016/j.jvir.2019.10.022. Epub 2020 Jan 22.
This study evaluated the safety and efficacy of the JETi8 peripheral thrombectomy system in treating acute deep vein thrombosis (DVT).
A retrospective study was conducted in 18 consecutive patients (mean age, 41 years old [range, 15-74 years old]; 5 men and 13 women). There were 21 instances of DVTs (9 iliofemoral, 10 axillosubclavian, and 2 portal), which were treated using the JETi8 thrombectomy device between November 2016 and July 2018. Thrombus was laced with recombinant tissue plasminogen activator (r-TPA) (9.3 mg, on average; range, 2-12 mg) in 17 procedures (81%) prior to thrombectomy. Technical success was defined as restoration of antegrade flow using the JETi8 with or without additional treatment of an underlying obstructive lesion. Procedural success was defined as technical success with or without the addition of overnight catheter-directed thrombolysis (CDT) RESULTS: Mean procedure time was 83 minutes (range, 30-160 minutes), and mean thrombus reduction with the JETi8 alone was 92% (range, 60%-100%). Stent placement was required in 6 procedures (29%). Technical success using the JETi8 system alone was 76% (16 of 21 procedures), whereas 5 procedures (24%) required subsequent overnight CDT in the intensive care unit. Procedural success rate was 100% (20 of 20 procedures). Mean aspirated volume was 531 mL (range, 250-1,230 mL). The only adverse event was a subsegmental pulmonary embolism. Seven patients (33%) were discharged the same day. Recurrent thrombosis was observed in 5 patients (24%), of whom 3 were successfully treated with the JETi8 system.
The JETi8 system may be a safe and effective option for thrombectomy of acute DVT.
本研究评估了JETi8外周血栓切除术系统治疗急性深静脉血栓形成(DVT)的安全性和有效性。
对18例连续患者(平均年龄41岁[范围15 - 74岁];5例男性和13例女性)进行了一项回顾性研究。共有21例DVT(9例髂股静脉、10例腋锁骨下静脉和2例门静脉),于2016年11月至2018年7月期间使用JETi8血栓切除术装置进行治疗。在17例手术(81%)中,血栓切除术之前用重组组织型纤溶酶原激活剂(r - TPA)(平均9.3mg;范围2 - 12mg)处理血栓。技术成功定义为使用JETi8恢复顺行血流,无论是否额外处理潜在的阻塞性病变。手术成功定义为技术成功,无论是否加用过夜导管定向溶栓(CDT)。结果:平均手术时间为83分钟(范围30 - 160分钟),单独使用JETi8时平均血栓减少率为92%(范围60% - 100%)。6例手术(29%)需要放置支架。单独使用JETi8系统的技术成功率为76%(21例手术中的16例),而5例手术(24%)随后在重症监护病房需要进行过夜CDT。手术成功率为100%(20例手术中的20例)。平均抽吸体积为531mL(范围250 - 1230mL)。唯一的不良事件是亚段肺栓塞。7例患者(33%)在同一天出院。5例患者(24%)观察到复发性血栓形成,其中3例用JETi8系统成功治疗。
JETi8系统可能是急性DVT血栓切除术的一种安全有效的选择。