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目的:探讨AngioJet机械血栓清除装置在急性下肢深静脉血栓(DVT)治疗中的应用价值。方法:回顾性分析2016-01-2017-03我科收治的29例进行机械血栓清除术(PMT)的DVT患者,在临时性下腔静脉滤器保护下首先行PMT治疗,依据血管造影评价血栓清除率,对残存血管狭窄病变者予以成形治疗。出院后服用华法林或利伐沙班抗凝至少6个月,第1、3、6、12月返院复查下肢静脉彩超。结果:所有患者均行PMT治疗,术中DSA造影评估22例静脉血栓完全再通,达到清除率Ⅲ级,7例静脉血栓部分再通,达到清除率Ⅱ级。其中23例行狭窄髂静脉球囊扩张,21例行支架植入;所有患者无手术相关的严重并发症发生,随访期内1例患肢肿胀复发,行闭塞髂静脉支架植入后症状消失。其余患者无病变血管管腔血栓复发。结论:AngioJet机械血栓抽吸装置可迅速减轻血栓负荷,提高管腔完全再通率,在急性下肢深静脉血栓治疗中安全、有效,值得进一步推广应用。
Objective: To investigate the value of AngioJet mechanical thrombectomy device in the treatment of acute deep vein thrombosis (DVT). Methods: A retrospective analysis of 29 patients with DVT who underwent mechanical thrombectomy (PMT) in our department from January 2016 to March 2016 was performed first with PMT under the protection of temporary inferior vena cava filter and thrombus removal by angiography Rate, residual vascular stenosis lesions to be shaped treatment. After discharge from the hospital to take warfarin or rivaroxaban anticoagulation at least 6 months, 1, 3, 6, December to review the venous venous ultrasonography. Results: All the patients underwent PMT. Intraoperative DSA angiography was used to evaluate the complete recanalization of venous thrombi in 22 patients. The clearance rate reached grade Ⅲ and the recanalization of venous thrombosis was achieved in 7 patients. The clearance rate reached grade Ⅱ. Among them, 23 patients underwent balloon dilatation of the narrow iliac vein and 21 patients underwent stent implantation. No operative complications were found in all patients. One patient suffered from swelling and recurrence during the follow-up period. The symptoms disappeared after occlusion of the iliac vein stent. The remaining patients without disease recurrence of vascular thrombosis. Conclusion: The AngioJet mechanical thrombus aspiration device can quickly reduce the thrombus load and improve the complete recanalization rate of the lumen. It is safe and effective in the treatment of acute deep venous thrombosis of the lower extremity. It is worth to be further popularized and applied.