Murray J G, Brown A L, Wilkins R A
Department of Radiology, Northwick Park Hospital, Harrow, Middlesex.
Clin Radiol. 1994 Aug;49(8):553-8. doi: 10.1016/s0009-9260(05)82936-8.
Percutaneous aspiration thromboembolectomy (PAT) is a radiological alternative to surgical embolectomy or thrombolysis in the treatment of acute arterial thromboembolic disease. We report our experience in eight patients aged 63-83 years (mean 71 years). Indications were graft thrombosis (1) or emboli from atrial fibrillation (3), abdominal aneurysm (2) or proximal angioplasty (2). PAT was performed at 10 arterial sites; common iliac (1), profunda femoris (1), superficial femoral (2), femoro-popliteal graft (1), popliteal (2) and arteries of the trifurcation (3). PAT was used as an adjunct to thrombolysis or angioplasty in five patients and as the sole procedure in three patients. It was successful in six patients (seven sites) with mean ABI rising from 0.4 pre- to 0.8 post-procedure. Two of the failures required amputations. One of these was a completely thrombosed dacron femoro-popliteal graft with poor run-off, and the second case had a failed surgical embolectomy prior to amputation. There were no major complications, and no mortality on follow-up at 1 month. PAT is a useful adjunct to thrombolysis and balloon angioplasty in the radiological treatment of acute thromboembolic disease. In patients in whom thrombolysis is contraindicated, it offers an alternative to surgical embolectomy.
经皮抽吸血栓切除术（PAT）是治疗急性动脉血栓栓塞性疾病时，手术取栓或溶栓的一种放射学替代方法。我们报告了8例年龄在63 - 83岁（平均71岁）患者的治疗经验。适应证包括移植血管血栓形成（1例）、房颤栓子（3例）、腹主动脉瘤（2例）或近端血管成形术（2例）。PAT在10个动脉部位进行；髂总动脉（1例）、股深动脉（1例）、股浅动脉（2例）、股腘动脉移植血管（1例）、腘动脉（2例）和三叉分支动脉（3例）。5例患者将PAT用作溶栓或血管成形术的辅助手段，3例患者将其作为唯一治疗方法。6例患者（7个部位）治疗成功，平均踝肱指数（ABI）从术前的0.4升至术后的0.8。2例失败患者需要截肢。其中1例是完全血栓形成的涤纶股腘动脉移植血管，远端血流不佳，另一例在截肢前手术取栓失败。无重大并发症，1个月随访时无死亡病例。PAT在急性血栓栓塞性疾病的放射学治疗中是溶栓和球囊血管成形术的有用辅助手段。对于溶栓禁忌的患者，它为手术取栓提供了一种替代方法。
