Rotarex机械血栓切除系统在下肢动脉血栓中的应用  

Application of lower extremity arterial thrombosis with Rotarex mechanical thrombectomy system

作　　者：张强[1] 游国超[1] 徐化静[1] 孔祥翔 杨殿滨 刘岩[1] ZHANG Qiang;YOU Guochao;XU Huajing;KONG Xiangxiang;YANG Dianbin;LIU Yan(Interventional Center,Anyang Regional Hospital of He'nan Province,Anyang,He'nan Province 455000,China)

机构地区：[1]河南安阳地区医院介入中心,河南安阳455000

出　　处：《实用放射学杂志》2024年第3期460-463,共4页Journal of Practical Radiology

摘　　要：目的探讨Rotarex机械血栓切除系统在下肢动脉血栓中的应用并评价其疗效.方法回顾性分析应用Rotarex治疗的61例(71条患肢)下肢动脉血栓患者临床资料,急性期35例,亚急性期21例,慢性期5例.远端流出道差的患者应用保护伞,鞘管连接高压滴注生理盐水,球囊扩张后出现限流型夹层者行支架置入.术中远端血管栓塞者联合导管抽吸取栓.血栓栓塞患者术后抗凝治疗,原位血栓形成患者术后双抗治疗.术后1月、3月、6月彩色多普勒超声或CT血管成像(CTA)随访.结果59例应用6F Rotarex治疗,2例应用8F Rotarex治疗.10例应用保护伞,49例行球囊扩张治疗,5例支架置入,10例联合应用导管吸栓;4例血管破裂,3例球囊压迫成功止血,1例胫腓干破裂应用覆膜支架修复.严重不良事件4例,围术期截趾7例.随访3~6月(平均4.9月),1例6月后再次出现缺血症状,行支架治疗,余随访期间无下肢缺血症状发生.结论Rotarex机械血栓切除系统治疗下肢动脉血栓,具有微创、快速、高效的优点,联合导管抽吸、支架置入等方法,可进一步维持血管通畅,快速缓解下肢缺血症状.Objective To investigate the application of Rotarex mechanical thrombectomy system in lower extremity arterial thrombosis and to evaluate its clinical efficacy.Methods The clinical data of 61 patients(71 limbs,35 cases in acute phase,21 cases in subacute phase and 5 cases in chronic phase)with lower extremity arterial thrombosis treated with Rotarex were analyzed retro-spectively.Distal protective device was used in patients with poor distal artery outflow.High pressure saline was used during the pro-cedure and stent was used in patients with flow-limiting dissection.Catheter aspiration was performed in patients with distal artery embo-lization.Anticoagulant therapy was used in patients with thromboembolism and dual antiplatelet therapy was used in patients with in-situ thrombosis.Postoperative follow-up was performed with color Doppler ultrasound or computed tomography angiography(CTA)at 1 month,3 months and 6 months.Results Fifty-nine cases were treated with 6F Rotarex catheters and 2 cases were treated with 8F Rotarex catheters.Distal protective device was used in 10 cases,balloon dilation was performed in 49 cases and stent was used in 5 cases.Catheter aspiration was performed in 10 cases.Vessel rupture occurred in 4 cases,among whom 3 cases were successfully treated with the method of balloon compression and 1 case was treated with covered stent.Severe adverse events occurred in 4 cases and perioperative toe amputation was performed in 7 cases.Follow-up time was 3 to 6 months(mean 4.9 months).Lower extremity ischemic event occurred in 1 case at 6th month follow-up and was treated with stent.No other lower extremity ischemic events occurred in the course of follow-up.Conclusion For the treatment of lower extremity arterial thrombosis,Rotarex mechanical thrombectomy sys-tem has the advantages of minimally invasion,rapid and high efficiency.Combined with the therapy of catheter aspiration and stent place-ment,vascular patency can be further maintained and the lower extremity ischemic symptoms can be quickly rel

关 键 词：下肢动脉血栓 Rotarex 经皮血栓切除 介入治疗 

分 类 号：R658.3[医药卫生—外科学] R815[医药卫生—临床医学]