Rotarex机械血栓清除术治疗股腘动脉血栓所致急性下肢缺血

目的观察Rotarex经皮机械血栓清除术(PMT)治疗股腘动脉血栓形成所致急性下肢缺血(ALI)的有效性及安全性。方法回顾性分析22例股腘动脉血栓致ALI患者,均采用Rotarex装置行PMT,观察治疗效果及并发症。结果 22例均顺利完成PMT;其中4例辅以经导管接触性溶栓治疗,17例联合球囊扩张术,12例行支架植入术。术后股腘动脉均再通,技术成功率100%,踝肱指数较术前显著增加(P0.05)。22例中,21例临床有效,术后Rutherford分级均改善;1例临床无效,3周后接受坏死足趾切除术。PMT术中发生远端动脉栓塞1例,血管夹层1例。1例术后6个月股浅动脉支架内再闭塞,1例术后9个月下肢动脉血栓复发。结论采用Rotarex装置行PMT治疗股腘动脉血栓所致ALI疗效好,安全性高。

Rotarex mechanical thrombectomy for treatment of acute limb ischemia caused by femoropopliteal artery thrombosis

Objective To observe the efficacy and safety of percutaneous mechanical thrombectomy (PMT) using Rotarex device for treatment of acute limb ischemia (ALI) caused by femoropopliteal artery thrombosis. Methods Data of 22 patients with ALI caused by femoropopliteal artery thrombosis treated with PMT using Rotarex device were retrospectively analyzed. The therapeutic effect and complications were observed. Results PMT was successfully performed in all 22 patients, combined with catheter-directed thrombolysis in 4 patients, with balloon dilatation in 17 and stent implantation in 12 patients. Femoropopliteal arteries were recanalized in all 22 patients, the technique success rate was 100%, and the ankle brachial index significantly increased after operation (P<0.05). After operation, improvement of Rutherford grade was observed in 21 except 1 patient who underwent resection of necrotic toes 3 weeks after operation. Distal artery embolism and vascular dissection occurred respectively in 1 patient during PMT. During follow-up period, in-stent reocclusion of the superficial femoral artery occurred in 1 patient 6 months after operation, while thrombus of the lower limb artery recurred in 1 patient 9 months after operation. Conclusion PMT using Rotarex device is safe and feasible for treatment of ALI caused by femoropopliteal artery thrombosis.