AngioJet血栓清除装置在急性下肢动脉缺血治疗中的应用效果  

Application effect of the AngioJet thrombectomy device in the treatment of acute lower limb ischemia

作　　者：林小雷 徐立 李文献 高金辉 Lin Xiaolei;Xu Li;Li Wenxian;Gao Jinhui(Department of Vascular Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,Fujian,China)

机构地区：[1]福建医科大学附属漳州市医院血管外科,福建漳州363000

出　　处：《血管与腔内血管外科杂志》2021年第6期698-702,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨AngioJet血栓清除装置治疗急性下肢动脉缺血的效果。方法收集2019年6月至2020年10月福建医科大学附属漳州市医院收治的8例急性下肢动脉缺血患者的临床资料,患者均行AngioJet血栓清除装置治疗,其中Ⅱa期3例,Ⅱb期4例,Ⅲ期1例,分析其临床效果及安全性。结果8例患者的手术成功率为100%,下肢恢复血流的平均时间为(1.6±0.7)h,其中1例患者因术后下肢动脉远端血运未改善而行截肢,保肢率为87.5%(7/8)。吸栓后,3例患者的股浅动脉存在局限性狭窄,行球囊扩张成形术+支架置入术。手术血栓清除率(Ⅲ级)5例,(Ⅱ级)2例,(Ⅰ级)1例。术后,患肢的即刻踝肱指数(ABI)为(0.75±0.07),明显高于术前的(0.34±0.03)(P<0.01)。所有患者均未发生出血、肾功能不全、骨筋膜室综合征。无死亡病例。结论在急性下肢动脉缺血的治疗中,应用AngioJet血栓清除装置能够快速清除血栓,恢复下肢血流,提高保肢率,降低截肢平面,创伤小,临床应用安全。Objective To investigate the effect of the AngioJet thrombectomy device in the treatment of acute lower limb arterial ischemia.Method The clinical data of 8 patients with acute lower limb arterial ischemia admitted to the Zhangzhou Affiliated Hospital of Fujian Medical University from June 2019 to October 2020 were collected.All patients were treated with AngioJet thrombectomy device,including 3 cases of stageⅡa,4 cases of stageⅡb,and 1 case in stageⅢ.Its clinical effect and safety were analyzed.Result The operation success rate of 8 patients was 100%,and the average time to restore blood flow towards the lower limb was(1.6±0.7)hours.One patient suffered an amputation because the blood flow to the distal arteries of the lower limb did not improve after the operation.The limb salvage rate was 87.5%(7/8).After thrombus aspiration,3 patients had limited stenosis of the superficial femoral artery and underwent balloon dilatation plus stent implantation.The surgical thrombus clearance was operated in 5 cases(GradeⅢ),2 cases(GradeⅡ),and 1 case(Grade I),respectively.After the operation,the immediate ankle brachial index(ABI)of the affected limb was(0.75±0.07),which was significantly higher than the preoperative(0.34±0.03)(P<0.01).No bleeding,renal insufficiency,or compartment syndrome was reported in all cases.No patient died was reported.Conclusion In the treatment of acute lower limb arterial ischemia,the application of the AngioJet thrombectomy system could quickly remove thrombus,restore lower limb blood flow,improve limb salvage rate,reduce amputation plane with minor trauma,and great safety in clinical application.

关 键 词：AngioJet血栓清除装置 经皮机械血栓清除术 急性 下肢动脉 缺血 

分 类 号：R543[医药卫生—心血管疾病]