AngioJet血栓清除术治疗存在溶栓禁忌证的急性下肢深静脉血栓

目的观察AngioJet血栓清除术对存在溶栓禁忌证的急性下肢深静脉血栓形成(LEDVT)的治疗效果。方法对18例存在溶栓禁忌证的急性LEDVT患者先行下腔静脉滤器置入术,而后行AngioJet血栓清除术;对合并髂静脉闭塞患者行髂静脉成形术。术后随访,观察治疗效果及安全性。结果18例均一次性治疗成功,血栓均完全清除;12例合并左髂静脉闭塞,均成功行血管成形术;18例患侧下肢静脉血流均恢复通畅。术后16例出现血红蛋白尿,无出血、肺栓塞等并发症。对16例随访3~37个月,13例下肢静脉血流通畅,3例血栓复发。结论采用AngioJet血栓清除术治疗存在溶栓禁忌证的LEDVT患者临床疗效较好。

Effects of AngioJet thrombectomy for treating acute lower extremity deep venous thrombosis in patients with contraindication of thrombolysis

Objective To evaluate the therapeutic effects of AngioJet thrombectomy in treatment of acute lower extremity deep venous thrombosis (LEDVT)in patients with contraindication of thrombolysis. Methods Eighteen acute LEDVT patients with contraindications for thrombolysis underwent inferior vena cava filter placement and then AngioJet thrombectomy. Iliac vein angioplasty was performed in patients with iliac vein occlusion. Follow-up was conducted to observe the efficacy and safety of these treatments. Results All 18 patients were successfully treated, and the thrombi were completely cleared. Twelve patients with left iliac vein occlusion underwent angioplasty. Blood flow of lower extremity vein in the affected sides remained fluent after interventional treatments in all 18 patients. Postoperative hemoglobinuria occurred in 16 patients. No severe complication such as bleeding nor pulmonary embolism occurred. Sixteen patients were followed up for 3-37 months, and venous blood flow of lower limbs were patent in 13 patients, while thrombi recurred in 3 patients. Conclusion AngioJet thrombectomy was safe and effective for treating acute LEDVT in patients with contraindication of thrombolysis.