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应用 Kissing Y-Solitaire 机械取栓术治疗老年难治性急性腘动脉和膝下动脉闭塞

Mechanical Thrombectomy Using Kissing Y-Solitaire as a Rescue Treatment for Refractory Acute Popliteal and Infrapopliteal Occlusion in Elderly Patients.

作者信息

Gong Maofeng, Zhou Yangyi, He Xu, Chen Liang, Su Haobo

机构信息

Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.

Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.

出版信息

J Vasc Interv Radiol. 2021 Nov;32(11):1601-1605. doi: 10.1016/j.jvir.2021.08.012.

Abstract

Six patients were included to retrospectively review the preliminary efficacy and safety of mechanical thrombectomy using kissing Y-Solitaire as a rescue treatment. This technique was performed following failed single Solitaire thrombectomy in 5 patients (5/6), and the remaining patient (1/6) underwent unsuccessful AngioJet thrombectomy (Boston Scientific, Marlborough, Massachusetts). The ranges of the target vessel clot length and diameter were 4.9-6.9 mm and 27-38 mm, respectively. Technical success was achieved in all patients (6/6). They (6/6) had notable acute limb ischemia (ALI) symptom relief after 1 or 2 passes of retrieval, and clinical success was achieved in all patients (6/6). No complications were observed other than reversible vasospasm in 1 patient (1/6). Amputation or death did not occur. Mechanical revascularization with the use of kissing Y-Solitaire seems to be a potentially rapid, safe, and effective modality for selected patients with refractory short-segment occlusion of ALI secondary to popliteal and infrapopliteal arteries.

摘要

纳入 6 例患者,回顾性分析应用 Y 型 Solitaire 支架取栓术作为补救性治疗的初步疗效和安全性。该技术应用于 5 例(5/6)患者的单纯 Solitaire 取栓术失败后,其余 1 例(1/6)患者行 AngioJet 血栓切除术(波士顿科学公司,马萨诸塞州马尔伯勒)失败。目标血管血栓长度和直径范围分别为 4.9-6.9mm 和 27-38mm。所有患者(6/6)均达到技术成功。在 1 或 2 次取栓后,所有患者(6/6)的急性肢体缺血(ALI)症状均显著缓解,所有患者(6/6)均达到临床成功。除 1 例(1/6)患者出现可逆性血管痉挛外,无其他并发症。对于因腘动脉和胫后动脉引起的难治性短节段 ALI 的选择性患者,使用 Y 型 Solitaire 支架取栓术似乎是一种快速、安全且有效的机械再通方式。

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