摘要
目的探讨机械性抽栓治疗导管接触溶栓(CDT)失败后滤器源性症状性下腔静脉-髂静脉血栓形成的可行性。方法收集2011年7月至2018年4月采用机械性抽栓治疗的8例CDT失败后滤器源性症状性下腔静脉-髂静脉血栓形成患者临床和影像学资料,对手术成功率、并发症发生率和随访情况进行统计分析。结果8例患者机械性抽栓手术均获成功,共取出完整滤器8枚。术后DSA造影未见下腔静脉穿孔和对比剂外溢,肺动脉造影未发现肺栓塞(PE)征象,超声复查无腹腔积液。吸出血栓病理学检查证实均为混合型血栓,未见血管壁等其它病理组织。术后随访6个月,下肢和下腔静脉血管超声无血栓影像,患者未出现下肢肿胀、疼痛、出血和PE症状。结论机械性抽栓可有效治疗CDT治疗失败后滤器源性症状性下腔静脉-髂静脉血栓形成,安全性高,具有较高的临床运用价值。
Objective To discuss the feasibility of mechanical thrombectomy in treating filter-induced symptomatic inferior vena cava-iliac(IVC-iliac)vein thrombosis which is carried out after catheter-directed thrombolysis(CDT)failed.Methods The clinical data and imaging materials of 8 patients with filter-induced symptomatic IVC-iliac vein thrombosis,who received mechanical thrombectomy after failure of CDT during the period from July 2011 to April 2018,were collected.The technical success rate,incidence of complications and follow-up results were statistically analyzed.Results The successful mechanical thrombectomy was accomplished in all 8 patients,and a total of 8 complete filters were retrieved.Postoperative DSA showed that no IVC perforation or extravasation of contrast agent was observed.Pulmonary angiography indicated that no signs of pulmonary embolism(PE)were detected.No abdominal effusion was found on ultrasonographic reexamination.Pathological examination confirmed that all the removed thrombus was of mixed type,and no other pathological tissues,such as vascular wall,were found.The patients were followed up for 6 months.Vascular ultrasonography of lower limbs and IVC showed no ultrasonographic manifestations of thrombus.No swelling,pain,hemorrhage of lower extremities,or PE symptom was observed in all patients.Conclusion Mechanical thrombectomy can effectively treat filter-induced symptomatic IVC-iliac vein thrombosis after failure of CDT with high safety.This technique has high clinical application value.
作者
徐燕能
袁罡
胡伟
郑波
张训
徐书豪
罗建明
张向琼
马小燕
斯光晏
周道益
XU Yanneng;YUAN Gang;HU Wei;ZHENG Bo;ZHANG Xtm;XU Shuhao;LUO Jianming;ZHANG Xiangqiong;MA Xiaoyan;SI Guangyan;ZHOU Daoyi(Department of Interventional Diagnosis and Treatment,Affiliated Hospital of Traditional Chinese Medicine,Southwest Medical University,Luzhou,Sichuan Province 646000,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第12期1136-1139,共4页
Journal of Interventional Radiology
关键词
下腔静脉
骼静脉
血栓
滤器
介入治疗
inferior vena cava
iliac vein
thrombus
filter
interventional therapy
