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目的:探讨数字血管减影(DSA)下机械吸栓配合置管溶栓术对急性髂股静脉血栓形成治疗的安全性和临床疗效。方法:对10例下肢累及髂股静脉血栓病人先置入Celect下腔静脉滤器,然后采用DSA下经患侧腘静脉顺穿置入Aspirex静脉吸栓导管分段吸除髂股静脉内血栓,如髂静脉受压予12mm球囊扩张,后配合unifuse溶栓导管置管溶栓。溶栓24h后造影,酌情髂总静脉置入支架,并维持抗凝治疗6-12个月,术后3-6月回收Celect下腔静脉滤器。结果:10例患者均手术顺利,术后全组患肢症状均明显缓解,3月复查全部患肢髂股静脉通畅,临床症状消失,6月内滤器全部取出,随访期间2例存在下肢深静脉轻度返流现象。结论:DSA下机械导管吸栓配合置管溶栓对急性髂股深静脉血栓治疗具有安全、微创、高效的临床特点,值得临床推广。
Objective: To investigate the safety and clinical efficacy of mechanical aspiration combined with catheterization thrombolysis in the treatment of acute iliofemoral venous thrombosis under digital subtraction angiography (DSA). Methods: Ten patients with lower extremity involvement of iliofemoral venous thrombosis were placed in Celect inferior vena cava filter, and then by DSA by the ipsilateral paraventricular vein into the Aspirex intravenous aspiration catheter embolectomy iliac vein thrombosis, such as Implantation of iliac vein to 12mm balloon dilatation, followed by unifuse thrombolytic catheter catheterization. Thrombolytic 24h after angiography, as appropriate iliac vein implantation stent, and maintain anticoagulant therapy for 6-12 months, 3-6 months after the recovery of Celect inferior vena cava filter. Results: All the 10 patients underwent surgery successfully. All the patients’ limb symptoms were relieved after operation. The iliac femoral vein was unobstructed in all limbs in March and the clinical symptoms disappeared. All the filters were removed in June. During the follow-up period, Mild reflux phenomenon. Conclusion: DSA with mechanical catheter thrombectomy combined with catheter thrombolysis is safe, minimally invasive and effective in the treatment of acute iliofemoral venous thrombosis, which is worthy of clinical promotion.