Dotter Department of Interventional Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
Cardiovasc Intervent Radiol. 2020 Sep;43(9):1398-1401. doi: 10.1007/s00270-020-02570-x. Epub 2020 Jun 29.
Advanced cases of phlegmasia cerulea dolens (PCD) with absent pedal pulses, sensory/motor deficits, and/or venous gangrene likely require more rapid restoration of flow compared to cases without these factors to prevent progression and associated morbidity/mortality. We present a case of PCD with absent pedal pulses and sensory deficit managed successfully with emergent percutaneous mechanical thrombectomy using Inari ClotTriever (Inari Medical, Irvine, CA) with immediate clinical resolution, including restoration of pedal pulses ~ 45 min after thrombectomy. Percutaneous mechanical thrombectomy with the ClotTriever device has the ability to immediately restore venous flow reversing the pathophysiology of PCD in a short time period similar to surgical embolectomy and may be an alternative treatment strategy in patients with phlegmasia cerulea dolens of high severity.
对于存在蓝趾综合征（PCD）晚期病例伴有足背动脉搏动消失、感觉/运动障碍和/或静脉坏疽的患者，与无这些因素的患者相比，可能需要更迅速地恢复血流，以防止病情进展和相关的发病率/死亡率。我们报告了一例 PCD 伴有足背动脉搏动消失和感觉缺失的病例，采用 Inari ClotTriever（Inari Medical，加利福尼亚州欧文）进行紧急经皮机械血栓切除术成功治疗，术后即刻临床缓解，包括在血栓切除术后 45 分钟左右恢复足背动脉搏动。ClotTriever 装置的经皮机械血栓切除术能够立即恢复静脉血流，在短时间内逆转 PCD 的病理生理学，与手术取栓术相似，对于病情严重的蓝趾综合征患者，可能是一种替代治疗策略。
