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经皮血栓切除术治疗下肢深静脉血栓形成:112例中期随访结果及分析

Percutaneous Thrombectomy for the Treatment of Lower Extremity Deep Vein Thrombosis: Medium-Term Follow-up Results and Analysis of 112 Cases.

作者信息

Cetin Hakki Kursat, Sevgili Emrah

机构信息

Cardiac Surgery, Sisli Etfal Training and Research Hospital, Istanbul, TUR.

Cardiology, Avcilar Hospital, Istanbul, TUR.

出版信息

Cureus. 2022 Feb 28;14(2):e22689. doi: 10.7759/cureus.22689. eCollection 2022 Feb.

Abstract

Introduction The aim of this study was to analyze percutaneous thrombectomy (PT) outcomes for the management of lower extremity deep vein thrombosis (DVT) with medium-term follow-up. Methods The study included charts of patients who underwent PT due to lower extremity DVT between August 2017 and March 2021. Patient characteristics and procedure outcomes were recorded in the electronic information system on the same day as the procedure. The procedures with complete removal of thrombus following PT without requiring additional procedure or additional thrombectomy apparatus were considered successful. Also, duration of follow-up was noted. Results In total, 112 patients were enrolled in the study. The femoropopliteal (40.2%) and iliofemoral (25.0%) veins were the most common sites with thrombus detected. The duration of PT procedure and fluoroscopy were 123.1 minutes and 21.9 minutes, respectively. Estimated blood loss was 255.1 milliliters. The hospital stay and intensive care unit stay following PT were 3.7 and 1.4 days, respectively. Major hemorrhage did not occur in any patient, but we encountered bradycardia in six (5.4%) patients, acute renal failure in one (0.9%) patient, hemoglobinuria in 11 (9.8%) patients, leg pain in 15 (13.4%) patients, and pulmonary embolism in 2 (1.8) patients, respectively. Success of the present study was 94.6% in the first month, and re-operation was required only in one patient. The mean follow-up period was 21.1 months with 90.2% venous patency rates. Conclusion The present study demonstrated that PT was an effective and reliable treatment modality with acceptable complication rates for the treatment of lower extremity DVT. Additionally, the efficacy of PT was proven by mid-term follow-up results.

摘要

引言 本研究的目的是分析中期随访下肢深静脉血栓形成(DVT)患者经皮血栓切除术(PT)的疗效。方法 本研究纳入了2017年8月至2021年3月因下肢DVT接受PT治疗的患者病历。患者特征和手术结果于手术当天记录在电子信息系统中。PT后血栓完全清除且无需额外手术或额外血栓切除装置的手术被视为成功。同时记录随访时间。结果 本研究共纳入112例患者。股腘静脉(40.2%)和髂股静脉(25.0%)是最常检测到血栓的部位。PT手术时间和透视时间分别为123.1分钟和21.9分钟。估计失血量为255.1毫升。PT后的住院时间和重症监护病房停留时间分别为3.7天和1.4天。所有患者均未发生大出血,但分别有6例(5.4%)患者出现心动过缓、1例(0.9%)患者出现急性肾衰竭、11例(9.8%)患者出现血红蛋白尿、15例(13.4%)患者出现腿痛、2例(1.8%)患者出现肺栓塞。本研究第一个月的成功率为94.6%,仅1例患者需要再次手术。平均随访期为21.1个月,静脉通畅率为90.2%。结论 本研究表明,PT是治疗下肢DVT的一种有效且可靠的治疗方式,并发症发生率可接受。此外,中期随访结果证实了PT的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c32c/8966689/3cf1dbcf9ced/cureus-0014-00000022689-i01.jpg

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