Su Yi-Jia, Chang Hsien-Yuan, Li Yi-Heng
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University.
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Acta Cardiol Sin. 2021 Nov;37(6):566-573. doi: 10.6515/ACS.202111_37(6).20210505B.
Thrombolytic therapy plays an important role in treating venous thromboembolic events in patients with unstable hemodynamics or compromised limb circulation. Standard catheter-directed thrombolysis requires a lower dosage of thrombolytic agents than systemic thrombolysis, thus lowering the risk of bleeding. Pharmacomechanical catheter- directed thrombolysis further decreases the dose of thrombolytic agents and duration of infusion. Percutaneous mechanical thrombolysis may potentially become an alternative for patients not suitable for thrombolytic agents. With an increasing number of devices and ongoing trials, endovascular therapy is a promising development that may improve both safety and efficacy in treating venous thromboembolic diseases.
溶栓治疗在治疗血流动力学不稳定或肢体循环受损患者的静脉血栓栓塞事件中发挥着重要作用。标准导管定向溶栓所需的溶栓剂剂量低于全身溶栓，从而降低了出血风险。药物机械性导管定向溶栓进一步降低了溶栓剂剂量和输注持续时间。经皮机械溶栓可能成为不适合使用溶栓剂患者的一种替代方法。随着设备数量的增加和正在进行的试验，血管内治疗是一个有前景的发展方向，可能会提高治疗静脉血栓栓塞性疾病的安全性和有效性。
