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急性近端深静脉血栓形成手动抽吸血栓切除术的长期疗效

Long-term outcome of manual aspiration thrombectomy for acute proximal deep vein thrombosis.

作者信息

Tsuji Akihiro, Hayashi Hiroya, Takano Ryo, Horinouchi Hiroki, Kotoku Akiyuki, Fujisaki Shinya, Endo Hiroyuki, Nishi Naruhiro, Kiko Takatoyo, Asano Ryotaro, Ueda Jin, Aoki Tatsuo, Fukuda Tetsuya, Ogo Takeshi

机构信息

Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.

Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan.

出版信息

Cardiovasc Interv Ther. 2025 Oct;40(4):890-899. doi: 10.1007/s12928-025-01168-9. Epub 2025 Jul 31.

Abstract

Manual aspiration thrombectomy (MAT) is a catheter intervention for cases with a high risk of bleeding. It is a rapid, simple, inexpensive, and single-session intervention for patients with proximal deep vein thrombosis (DVT). We evaluated the long-term outcome of MAT for patients with proximal DVT. All consecutive patients with acute proximal DVT treated at our center from April 2012 to December 2022 were retrospectively screened. Twenty-one patients who underwent MAT were enrolled. We evaluated the incidence and clinical characteristics of post-thrombotic syndrome (PTS) post-MAT in the chronic phase. The venous clot burden extent was assessed using the venographic segment (VS) score during catheter intervention. We evaluated the pre- and post-treatment total VS score. PTS was evaluated by PTS onset at any time between 6 and 24 months. We compared the clinical characteristics of patients with and without PTS (PTS and non-PTS groups, respectively). PTS onset at any time between 6 and 24 months post-MAT was 33%. The PTS group had a significantly higher post-treatment total VS score and lower thrombus aspiration success rate than the non-PTS group. Furthermore, the PTS group had a significantly longer duration from onset to intervention than the non-PTS group. PTS onset post-MAT was 33% in the chronic phase. The PTS group showed a lower thrombus aspiration success rate and longer duration from DVT onset to intervention than the non-PTS group. These findings suggest that earlier and substantial thrombus reduction with MAT may be associated with a lower risk of PTS.

摘要

手动抽吸血栓切除术(MAT)是一种针对出血风险较高病例的导管介入治疗方法。对于近端深静脉血栓形成(DVT)患者,它是一种快速、简单、廉价且单次完成的介入治疗。我们评估了MAT治疗近端DVT患者的长期疗效。对2012年4月至2022年12月在我们中心接受治疗的所有连续性急性近端DVT患者进行了回顾性筛查。纳入了21例行MAT的患者。我们评估了慢性期MAT后血栓形成后综合征(PTS)的发生率和临床特征。在导管介入期间使用静脉造影段(VS)评分评估静脉血栓负荷程度。我们评估了治疗前后的总VS评分。PTS通过在6至24个月之间任何时间的PTS发作来评估。我们比较了有PTS和无PTS患者(分别为PTS组和非PTS组)的临床特征。MAT后6至24个月之间任何时间的PTS发作率为33%。PTS组治疗后的总VS评分显著高于非PTS组,血栓抽吸成功率低于非PTS组。此外,PTS组从发病到介入的持续时间显著长于非PTS组。慢性期MAT后PTS发作率为33%。与非PTS组相比,PTS组的血栓抽吸成功率较低,从DVT发病到介入的持续时间较长。这些发现表明,MAT早期大量减少血栓可能与较低的PTS风险相关。

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