下肢静脉顺行性CO2 -DSA的临床应用

目的探索经足背静脉行下肢静脉CO2-DSA的可行性及效果。方法15例患者(15条患肢)，男9例，女6例，临床疑为下肢深静脉血栓形成8例，大隐静脉曲张6例，下肢深静脉血栓溶栓术后复查1例。分别用8号头皮针经足背静脉行下肢静脉CO2-DSA。结果12例造影可清晰显示下肢浅、深静脉及其交通支，血栓、血管狭窄的位置及范围，图像质量优；2例造影图像质量良；1例因脚背严重水肿，多次足背静脉穿刺未成功而致造影失败。术中3例无任何不适反应；11例出现下肢一过性不适，主要表现在足背静脉穿刺点处一过性胀痛，其中6例下肢深静脉血栓形成患者感觉明显，停止注射不适感即除；本组未出现重度不良反应或并发症患者。结论下肢静脉顺行性CO2-DSA安全、可行，能够满足临床下肢静脉疾病的诊断要求，尤其是对于髂静脉、下腔静脉的显示效果尤件。

CO2-DSA in lower extremity veins: a clinical application

Objective To explore the feasibility and usefulness of carbon dioxide digital subtraction angiography (CO_2-DSA) in deep veins of lower extremity via the dorsalis pedis vein. Methods CO_2-DSA in lower extremity veins was performed in 15 patients (15 limbs affected, male 9, female 6) by injection of CO_2 via the dorsalis pedis vein. Among them, 8 patients were suspected with deep venous thrombosis (DVT), 6 patients with saphena magna dilation, and 1 patient with a follow-up after thrombolysis due to DVT. Results Excellent image was obtained in 12 cases, which showed branches of the venous system clearly, as well as the details of DVT. Good image was obtained in 2 cases. Technical failure was encountered in one patient due to inaccessible puncture veins. Mild discomfort (transient pain at the percutaneous site) during the procedure was demonstrated in 11 patients. There was no severe side effects or complications in this series. Conclusion CO_2-DSA in lower extremity veins is feasible and safe, the preliminary result is satisfactory.