AngioJet在慢性股腘动脉长段闭塞病变中的应用初步探索  

Preliminary exploration on the application of AngioJet in chronic femoral popliteal artery length occlusion

作　　者：袁涛[1] 毕伟[1] 高翔[1] 孙欢欢[1] 池魁[1] 王志波[1] 张金文[1] Yuan Tao;Bi Wei;Gao Xiang;Sun Huanhuan;Chi Kui;Wang Zhibo;Zhang Jinwen(Department of Vascular Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第二医院血管外科,河北石家庄050000

出　　处：《血管与腔内血管外科杂志》2021年第10期1256-1259,共4页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨AngioJet机械血栓抽吸技术腔内治疗慢性股腘动脉长段闭塞病变的有效性及安全性。方法收集2019年5月至2020年5月河北医科大学第二医院收治的15例慢性股腘动脉长段闭塞病变患者的临床资料。观察全部患者的术中机械血栓抽吸时间、尿激酶使用剂量、腔内介入治疗成功率及围手术期相关并发症的发生情况。比较抽吸前后的病变段长度。观察术后肌红蛋白尿的发生情况、血色素降低程度、术后即刻效应。比较术前、术后1周、术后6个月的踝肱指数(ABI),术前与术后6个月的Rutherford分级。观察术后6个月管腔丢失率和再干预率。结果15例慢性股腘动脉长段闭塞病变患者的腔内介入治疗成功率为100%(15/15)。围手术期,无死亡、心脑血管疾病、远端动脉栓塞或出血事件发生。术中机械血栓抽吸时间为(361.87±57.44)s,尿激酶使用剂量为(25.67±4.03)万U。抽吸后的平均病变段长度明显短于抽吸前,差异有统计学意义(P<0.01)。术后,有13例患者出现肌红蛋白尿,平均持续时间为(1.47±0.88)d。术后血色素较术前降低了(8.87±1.86)g/L。术后1例患者出现下肢肿胀,经硫酸镁持续湿敷后缓解。术后1周、术后6个月的ABI均高于术前,差异均有统计学意义(P<0.01)。术后6个月,管腔丢失患者2例,再干预患者1例。术后6个月,患者的Rutherford分级优于术前(P<0.05)。术后,造影检查结果显示,1例患者出现限流性夹层,植入一枚补救性支架。结论AngioJet机械血栓抽吸技术不仅能够有效去除慢性股腘动脉长段闭塞病变的血栓,缩短病变长度,降低病变狭窄率,还可有效降低远端栓塞风险,提高远期通畅率,并可减少留置溶栓导管所致的出血等不良事件的发生。Objective To explore the safety and effectiveness of AngioJet mechanical thrombus aspiration in the treatment of chronic femoral popliteal artery long-segment occlusive disease.Method The clinical data of 15 patients with chronic femoral popliteal artery long-segment occlusive disease treated in the Second Hospital of Hebei Medical University from May 2019 to May 2020 were collected.The intraoperative mechanical thrombus aspiration time,the dosage of urokinase,the success rate of endovascular interventional therapy and the incidence of perioperative related complications were observed.The length of lesion segment before and after suction was compared.The occurrence of myoglobinuria,the degree of hemoglobin reduction and the immediate effect were observed.Before operation,1 week after operation The ankle-brachial index(ABI)at 6 months after operation and Rutherford grade at 6 months before and after operation were observed.The lumen loss rate and re intervention rate at 6 months after operation were observed.Result The success rate of endovascular intervention in 15 patients with chronic long segment femoral popliteal artery occlusion was 100%(15/15).During the perioperative period,there was no death,cardiovascular and cerebrovascular disease,distal arterial embolism or bleeding.The intraoperative mechanical thrombus suction time was(361.87±57.44)s and the dosage of urokinase was(25.67±4.03)ten thousand U.The average lesion length after suction was significantly shorter than that before suction,and the difference was statistically significant(P<0.01).After operation,13 patients developed myoglobinuria,with an average duration of(1.47±0.88)d.The hemoglobin decreased by(8.87±1.86)g/L.One patient developed lower limb swelling after operation,which was relieved after continuous wet compress with magnesium sulfate.The ABI at 1 week and 6 months after operation was higher than that before operation,and the difference was statistically significant(P<0.01).At 6 months after operation,there were two patients with lumen

关 键 词：慢性 股腘动脉 闭塞 AngioJet 治疗效果 安全性 

分 类 号：R543[医药卫生—心血管疾病]