[1]张韬 张学民※ 张小明 李伟 李清乐 焦洋 蒋京军 李伟浩.机械血栓清除术治疗急性-亚急性股腘动脉支架内血栓21例[J].中国微创外科杂志,2019,01(2):127-131.
　Zhang Tao,Zhang Xuemin,Zhang Xiaoming,et al.Percutaneous Mechanical Thrombectomy for Recanalization of Acute and Subacute Thrombotic Femoropopliteal Artery Stent Occlusions[J].Chinese Journal of Minimally Invasive Surgery,2019,01(2):127-131.
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机械血栓清除术治疗急性-亚急性股腘动脉支架内血栓21例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年2期
页码:
127-131
栏目:
临床研究
出版日期:
2019-02-25

文章信息/Info

Title:
Percutaneous Mechanical Thrombectomy for Recanalization of Acute and Subacute Thrombotic Femoropopliteal Artery Stent Occlusions
作者:
张韬 张学民※ 张小明 李伟 李清乐 焦洋 蒋京军 李伟浩
（北京大学人民医院血管外科，北京100044）
Author(s):
Zhang Tao;  Zhang Xuemin;  Zhang Xiaoming;  et al.
Department of Vascular Surgery, Peking University People's Hospital, Beijing 100044, China
关键词:
机械血栓清除术; 血栓; 支架; 股动脉; 腘动脉
Keywords:
Mechanical thrombectomy; Thrombosis; Stent; Femoral artery; Popliteal artery
文献标志码:
A
摘要:
目的探讨机械血栓清除术（percutaneous mechanical thrombectomy，PMT）治疗急性-亚急性股腘动脉支架内血栓的疗效。方法2016年1月~2018年1月对21例因急性-亚急性股腘动脉支架内血栓行PMT(16例选择Rotarex机械血栓切除系统，5例选择AngioJet机械血栓切除系统)，17例辅助动脉置管溶栓（catheter directed thrombolysis，CDT）和经皮血管腔内成形术（percutaneous transluminal angioplasty，PTA）、支架成形术。结果病变长度（15.5±4.9）cm。技术成功率Angiojet组100%（5/5）；Rotarex组68.8%（11/16），5例联合CDT后成功率100%。辅助CDT 5例，残余病变行单纯PTA 12例，PTA辅助支架成形2例。临床成功率90.5%（19/21）。术后踝肱指数（anklebrachial index，ABI）中位数0.72（0.40～1.20），明显高于术前中位数0.26（0.00～0.76）（Z=-3.640，P=0.001）。远端动脉栓塞发生率28.6%（6/21），穿刺点出血3例（14.3%），无穿孔、夹层、支架移位和肾功能衰竭并发症。21例随访（13.5±6.1）月，6个月一期通畅率81.1%（17/21），二期通畅率100.0%（21/21），无死亡，1例（4.8%）术后2个月患足因坏疽合并感染行足部截肢。结论机械血栓清除术适用于急性-亚急性股腘动脉支架内血栓。
Abstract:
ObjectiveTo assess the effectiveness of percutaneous mechanical thrombectomy (PMT) in the treatment of acute and subacute thrombotic occlusions in stentgrafts of femoropopliteal artery.MethodsFrom January 2016 to January 2018, there were 21 patients with acute or subacute thromboses after stentgrafts of femoropopliteal artery. The patients were treated with PMT, 16 of which were treated by using the Rotarex mechanical thrombectomy device and 5 of which were treated by using the AngioJet device. Among them, 17 patients were given assisted catheter directed thrombolysis (CDT), percutaneoius transluminal angioplasty (PTA), or stent angioplasty.ResultsThe average lesion length was (15.5±4.9)cm. The immediate technical success rate was 100% (5/5) in the AngioJet group and 68.8% (11/16) in the Rotarex group. A total of 5 cases with combined CDT obtained a technical success rate of 100%. The residual lesions were treated with PTA in 12 cases and PTA assisted stent angioplasty in 2 cases. The overall clinical success rate was 90.5% (19/21). The median postoperative anklebranchial index was 0.72 (range, 0.40-1.20), which was significantly higher than preoperation ［0.26 (0.00-0.76), Z=-3.640, P=0.001］. The complication rate of distal embolization was 28.6% (6/21) and puncture hemorrhage happened in 3 cases (14.3%). There were no complications of perforation, dissection, stent displacement or renal failure. The followups for (13.5±6.1) months in 21 cases showed the primary patency rate of 81.1% (17/21) and the secondary patency rate of 100.0% (21/21) after 6 months. No fatal case was seen. One case (4.8%) suffered from foot gangrene and infection and underwent foot amputation 2 months after operation.ConclusionPMT is a choice for acute and subacute thrombosis of thrombotic femoropopliteal artery stent occlusions.

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备注/Memo

备注/Memo:
※通讯作者，Email:zhangxuemin128@126.com
更新日期/Last Update: 2019-04-28