Rotarex治疗急性/亚急性下肢动脉缺血的疗效分析  

Use of Rotarex mecha nical debulking in acute and subacute lower limb ischemia:17 cases report

作　　者：刘彬[1] 陈学明[1] 李晨宇[1] 冯海[1] 于宏志[1] 朱仁明[1] 房杰[1] 

机构地区：[1]首都医科大学附属北京友谊医院血管外科,北京100050

出　　处：《中国血管外科杂志（电子版）》2017年第4期266-268,292,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨Rotarex机械血栓切除系统在治疗急性/亚急性下肢动脉缺血性疾病中的手术疗效。方法回顾性分析2015年7月至2016年5月经Rotarex机械血栓切除系统治疗的17例急性/亚急性下肢动脉缺血性疾病的患者资料。患者入院后经下肢动脉彩超或下肢动脉CTA诊断明确,行介入手术治疗,行股动脉顺行或逆行穿刺置管,对下肢动脉病变行经皮血栓切除减容治疗,术中造影评估血运改善情况,术后评估患肢缺血情况,出院后予抗血小板及抗凝治疗,于术后半年进行门诊及彩超复查,评估手术疗效。结果全部手术患者缺血症状均得到缓解,顺利出院,手术技术成功率94.1%,围术期并发症1例,为血管破裂出血,术中经球囊扩张及外部压迫后止血,支架植入率29.4%,合并置管溶栓治疗23.5%。所有患者获得随访,6个月通畅率100%。结论对于下肢动脉急性/亚急性下肢动脉缺血性疾病,经皮血栓切除可取得良好效果,是除传统的股动脉切开取栓术外的一种微创新选择。Objective To evaluate the effectiveness and safety of percutaneous mechanical thrombectomy(PMT) in acute and subacute lower limb ischemia(ALI/SLI) with Straub device. Method Clinical data of 17 cases ALI/SLI admitted in hospital from Jul. 2015 to May 2016 were retrospectively analyzed. All cases were confirmed by Doppler ultrasounography or CTA examination. PMT device(Rotarex,Straub) was navigated to lesions antegradely or retrogradely from femoral artery access. Blood supply improvement was evaluated intraoperatively by flow angiography. All cases were administrated with antiplatelet or anticoagulation agents after discharged from hospital. After six months follow-up, the effectiveness and safety of therapy were observed. Results Technical success was 94.1%. One case experienced artery rupture, and the bleeding was stopped by intraoperative balloon compression. Stent were implanted in 29.4%cases and catheter-directed thrombolysis was performed in 23. 5 % cases. Symptoms of ischemia were released in all cases. During 6-month follow up, all treated arteries remained patent. Conclusion Treatment of ALI/SLI with PMT device achieves promising clinical outcome, and can be an alternative minimal invasive therapy to traditional thrombectomy.

关 键 词：急性/亚急性下肢动脉缺血 Rotarex 机械减容 经皮血栓切除 

分 类 号：R654.4[医药卫生—外科学]