AngioJet机械吸栓治疗腹主动脉瘤腔内修复术后髂支闭塞病变  

Angiojet Ultra thrombectomy for the treatment of limb endovascular aortic graft occlusion

作　　者：韩晓峰[1] 刘光锐[1] 李铁铮[1] 郭曦[1] Han Xiaofeng;Liu Guangrui;Li Tiezheng;Guo Xi(Department of Diagnostic and Interventional Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院介入诊疗科,100029

出　　处：《中华普通外科杂志》2020年第10期801-805,共5页Chinese Journal of General Surgery

基　　金：国家重点研发计划(2017YFC1308005)。

摘　　要：目的探讨AngioJet Ultra血栓清除装置在治疗腹主动脉瘤腔内修复术后髂动脉支架内闭塞病变中的应用价值。方法回顾性分析2014年12月至2019年11月肾下型腹主动脉瘤患者腹主动脉瘤腔内修复术后随访期间12例发生单侧髂动脉支架内闭塞并应用血栓清除装置治疗患者的临床资料。结果12例患者均为男性,平均年龄(63士12)岁,左侧髂支闭塞4例,右侧髂支闭塞8例,均使用AngioJet Ultra血栓抽吸装置联合髂支成形技术进行治疗且手术成功率为100%。9例分叉型覆膜支架患者使用AngioJet血栓抽吸联合球囊扩张成形术后置入支架成功。术后患者间歇性跛行/臀肌跛行症状消失,术后2例患者出现血红蛋白尿,其中1例患者发生轻度肾功能损害。中位随访时间18个月,无再发下肢缺血症状发生。结论腹主动脉瘤腔内修复术后髂支闭塞性病变使用AngioJet Ultra血栓抽吸装置进行辅助治疗,安全、有效。Objective To assess the value of Angiojet Ultra thrombectomy device in dealing with limb graft occlusion after endovascular repair for abdominal aortic aneurysm.Methods The clinical data of 12 unilateral limb graft occlusion cases treated with percutaneous mechanical thrombectomy(PMT)after endovascular aortic repair(EVAR)for abdominal aortic aneurysm(AAA)from Dec 2014 to Nov 2019 was retrospectively analyzed.Results All 12 patients were male,age ranging from(63±12)years old.Four cases had left iliac limb graft occlusion and eight cases had right iliac limb graft occlusion.All cases were treated with PMT and iliac branch angioplasty.Successful rate was 100%.Nine cases with bifurcated stentgraft were then implanted bare/covered stent.Postoperative intermittent claudication/gluteus claudication disappeared.Hemoglobinuria occurred in 2 cases after operation,in which one suffered from mild renal impairment and recovered.Median following-up time was 18 months,there was no recurrence of lower limb ischemia.Conclusion Application of Angiojet Ultra thrombectomy device in PMT treatment was safe,effective and less traumatic for iliac limb graft occlusion after endovascular anortic repair for abdominal aortic aneurysm.

关 键 词：血管成形术 缺血 髂支闭塞 

分 类 号：R654.3[医药卫生—外科学]