顺行插管综合介入治疗下肢深静脉慢性血栓形成

目的 评价顺行性插管对下肢深静脉慢性血栓形成（LEDVT）的综合介入治疗的临床应用价值。方法 40例髂和（或）股静脉长段，全段或多节段血栓形成的患者。均经健侧股静脉穿刺先置入下腔静脉滤器，然后经患侧Guo静脉穿刺插管。综合运用血管内溶栓，血栓抽吸，血栓消融器消融。球囊成形术及腔内支架置入术治疗。结果 经皮Guo静脉穿刺插管成功率87.5%(35/40)。失败的5例改手术切开暴露Guo静脉再穿刺插管成功。综合介入治疗后总有效率100%。其中治愈率42.5%（17/40），显效率47.5%(19/40)，好转率10.0%(4/40)。无严重并发症发生。结论 经皮Guo静脉顺行性穿刺插管途径和结合多项介入技术综合运用治疗慢性LEDVT是安全有效的方法。

Antegrade catheterization in comprehensive interventional treatment of chronic deep venous thrombosis in lower extremities

Objective To evaluate the clinical effectiveness of antegrade catheterization in combined interventional treatment of chronic lower extremity deep venous thrombosis (LEDVT). Methods Forty patients with thrombosis in longer segment, whole segment or multi-segments of the iliac and (or) femoral veins were included in the study. Inferior vena cava filters (IVCF) were placed in all patients via the normal femoral veins. Antegrade puncture and catheterization was carried out through the popliteal veins in the thrombotic side. Combined interventional therapies were accomplished, including intravascular thrombolysis, thrombosis aspiration, thrombosis amplification with Amplatz Thrombectomy Device (ATD), angioplasty, and implantation of stent. Results The successful rate of percutaneous catheterization in the popliteal veins was 87.5% (35/40). In the other five unsuccessful cases, the catheterization in the popliteal veins was achieved successfully after exposing the popliteal veins by operations. Total effective rate after combined interventional treatment was 100%. No serious complications were observed. Conclusion Combined interventional treatments of chronic LEDVT through the popliteal veins is safe and effective.