[1]公茂峰,顾建平,陈国平,等.AngioJet血栓清除术在急性下肢动脉缺血治疗中的应用 [J].介入放射学杂志,2017,(06):509-513.
 GONG Maofeng,GU Jianping,CHEN Guoping,et al.The application of percutaneous mechanical thrombectomy with AngioJet system in management of acute lower limb arterial ischemia[J].journal interventional radiology,2017,(06):509-513.
点击复制

AngioJet血栓清除术在急性下肢动脉缺血治疗中的应用



()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2017年06期
页码:
509-513
栏目:
血管介入
出版日期:
2017-06-25

文章信息/Info

Title:
The application of percutaneous mechanical thrombectomy with AngioJet system in management of acute lower limb arterial ischemia
作者:
公茂峰 顾建平 陈国平 何 旭 楼文胜 陈 亮 苏浩波 宋进华 施万印 汪 涛 赵伯翔 黄 昊 李英豪
Author(s):
GONG Maofeng GU Jianping CHEN Guoping HE Xu LOU Wensheng CHEN Liang SU Haobo SONG Jinhua SHI Wanyin WANG Tao ZHAO Boxiang HUANG Hao LI Yinghao
Department of Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province 210006, China
关键词:
【关键词】 AngioJet血栓清除装置 经皮机械血栓清除术 急性动脉缺血 保肢
文献标志码:
A
摘要:
【摘要】 目的 探讨AngioJet血栓清除术在治疗急性下肢动脉缺血(ALI)中的临床应用价值。方法 回顾性分析2015年1月至2016年11月经AngioJet血栓清除术治疗的12例ALI患者临床资料,以心肌梗死溶栓(TIMI)治疗后血流分级评估血流灌注情况,Cooley疗效评分标准评价临床疗效。结果 AngioJet血栓清除术技术成功率为91.7%(11/12),平均恢复灌注时间为(1.6±0.7) h。临床成功率为83.3%(10/12),保肢率为91.7%(11/12)。TIMI分级由术前0级8例, 1级4例,改善为术后即刻0级1例,1级3例,2级8例。11例(91.7%)下肢缺血症状有明显改善,1例(8.3%)术后虽经导管接触溶栓(CDT)治疗24 h,但TIMI分级仍0级且肢体缺血症状未改善,予以外科膝上截肢治疗。Cooley疗效评分显示,痊愈4例(33.3%),良好6例(50.0%),一般1例(8.3%),较差1例(8.3%),未发生严重出血并发症。结论 AngioJet血栓清除术可快速恢复ALI患者血流灌注,阻止病变进一步恶化,提高保肢率,有较好的临床应用价值。

参考文献/References:

[1] Gerhard- Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC Guideline on the Management of Patients with Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[J]. J Am Coll Cardiol, 2017, 69: e71- e126.
[2] Patel NH, Krishnamurthy VN, Kim S, et al. Quality improvement guidelines for percutaneous management of acute lower- extremity ischemia[J]. J Vasc Interv Radiol, 2013, 24: 3- 15.
[3] Galanakis N, Kontopodis N, Peteinarakis I. Direct stenting in patients with acute lower limb arterial occlusions: immediate and long- term results[J]. Cardiovasc Intervent Radiol, 2017, 40: 192- 201.
[4] Leung DA, Blitz LR, Nelson T, et al. Rheolytic pharmacome- chanical thrombectomy for the management of acute limb ischemia: results from the PEARL registry[J]. J Endovasc Ther, 2015, 22: 546- 557.
[5] Rutherford RB. Clinical staging of acute limb ischemia as the basis for choice of revascularization method: when and how to intervene[J]. Semin Vasc Surg, 2009, 22: 5- 9.
[6] 陈国平, 顾建平, 楼文胜, 等. 股深动脉血流重建改善下肢缺血的临床应用[J]. 介入放射学杂志, 2011, 20: 782- 786.
[7] Creager M, Kaufman JA, Conte MS, et al. Clinical practice.Acute limb ischeman[J]. N Engl J Med, 2012, 366: 2198- 2206.
[8] Hynes BG, Margey RJ, Ruggiero N 2nd, et al. Endovascular management of acute limb ischemia[J]. Ann Vasc Surg, 2012, 26: 110- 124.
[9] Yang H, Lei Q, Chen S, et al. Acute embolic occlusion of the right common iliac artery after revision total hip arthroplasty treated with catheter- directed thrombolysis and balloon angioplasty: a case report[J]. SAGE Open Med Case Rep, 2015, 3: 2050313X 15594836.
[10] Spiliopoulos S, Katsanos K, Fragkos G, et al. Treatment of infrainguinal thromboembolic complications during peripheral endovascular procedures with AngioJet rheolytic thrombectomy, intraoperative thrombolysis, and selective stenting[J]. J Vasc Surg, 2012, 56: 1308- 1316.
[11] Haskal ZJ. Mechanical thrombectomy devices for the treatment of peripheral arterial occlusions[J]. Rev Cardiovasc Med, 2002, 3(Suppl 2): s45- s52.
[12] Ballehaninna UK, Hingorani A, Ascher E, et al. Acute superior mesenteric artery embolism: reperfusion with AngioJet hydrody- namic suction thrombectomy and pharmacologic thrombolysis with the EKOS catheter[J]. Vascular, 2012, 20: 166- 169.
[13] 宋进华, 何 旭, 楼文胜, 等. 急性髂股静脉血栓治疗中AngioJet机械性血栓清除装置初步应用结果[J]. 中华放射学杂志, 2015, 49: 758- 762.
[14] 刘 凯, 段鹏飞, 陈 珑, 等. AngioJet血栓清除装置治疗急性下肢深静脉血栓形成初步临床应用[J]. 介入放射学杂志, 2016, 25: 496- 500.
[15] 张 娣, 顾建平. 急性肢体缺血的介入治疗[J]. 介入放射学杂志, 2011, 20: 832- 835.

备注/Memo

备注/Memo:
(收稿日期:2017-01-06)
(本文编辑:边 佶)
更新日期/Last Update: 2017-06-13