Görich J, Rilinger N, Sokiranski R, Krämer S, Mickley V, Schütz A, Brambs H J, Pamler R
Department of Radiology, University of Ulm, Germany.
AJR Am J Roentgenol. 1998 May;170(5):1177-80. doi: 10.2214/ajr.170.5.9574579.
Our objective was to evaluate the efficacy of the Amplatz thrombectomy device for recanalization of acute occlusions of both the superficial and the deep femoral arteries.
Eighteen patients with acute occlusions of the femoral arteries (eight male, 10 female; 10-87 years old) were treated using the Amplatz thrombectomy clot macerator. The duration of occlusion was 16 +/- 8 hr. Eighteen patients underwent treatment of the deep femoral artery, and 16 patients had additional involvement of the superficial femoral artery. After primary recanalization of the deep femoral artery, the superficial femoral artery was also recanalized using the Amplatz thrombectomy device. Nine patients required additional aspiration thrombectomy of the tibial arteries, five patients required additional aspiration thrombectomy of side branches of the deep femoral artery, and 12 patients required additional local thrombolysis with urokinase.
In 14 (78%) of 18 patients, recanalization of the deep femoral artery was complete without demonstrable residual thrombi. Arterial spasms were observed in five patients (28%). The rate of limb salvage was 94% at a mean follow-up interval of 8.9 +/- 4.1 months. In the 18 patients, the ankle-brachial pressure index went from a median value of 0.56 before therapy to a median value of 0.91 after therapy. No severe complications occurred.
Mechanical thrombolysis in the deep femoral artery with the Amplatz thrombectomy device is an effective, rapid method of treatment and is rarely associated with complications. In cases of concomitant occlusion of the tibial arteries, recanalization should always be attempted because the deep femoral artery may provide a functionally decisive collateral artery between the iliac and tibial vasculature.
我们的目的是评估Amplatz血栓切除术装置对股浅动脉和股深动脉急性闭塞再通的疗效。
18例股动脉急性闭塞患者（男8例，女10例；年龄10 - 87岁）使用Amplatz血栓切除碎栓器进行治疗。闭塞持续时间为16±8小时。18例患者接受了股深动脉治疗，16例患者的股浅动脉也受累。在股深动脉初次再通后，也使用Amplatz血栓切除术装置对股浅动脉进行再通。9例患者需要对胫动脉进行额外的抽吸血栓切除术，5例患者需要对股深动脉分支进行额外的抽吸血栓切除术，12例患者需要使用尿激酶进行额外的局部溶栓。
18例患者中有14例（78%）股深动脉完全再通，无明显残留血栓。5例患者（28%）观察到动脉痉挛。平均随访8.9±4.1个月时，肢体挽救率为94%。18例患者的踝肱压力指数从治疗前的中位数0.56升至治疗后的中位数0.91。未发生严重并发症。
使用Amplatz血栓切除术装置对股深动脉进行机械溶栓是一种有效、快速的治疗方法，且很少伴有并发症。在伴有胫动脉闭塞的情况下，应始终尝试进行再通，因为股深动脉可能在髂血管和胫血管之间提供功能上起决定性作用的侧支动脉。
