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目的:总结AngioJet血栓抽吸系统联合支架置入术治疗上肢深静脉血栓的有效性。方法:在浅静脉造影路图帮助下,于左侧肘横纹上于肱静脉顺行穿刺开通锁骨下静脉闭塞段后沿导丝送入AngioJet血栓抽吸导管,对左锁骨下静脉-左腋静脉血栓区域进行尿激酶腔内喷射。反复抽吸后造影可见静脉仍残留明显狭窄,于左锁骨下静脉放置Wallstent支架1枚,扩张后使用球囊进行后扩张,扩张后造影见左锁骨下静脉恢复通畅,未见明显残余狭窄,造影剂无外溢及滞留。结果:患者的手术时间为111min,术中出血量为10ml。患者行AngioJet血栓抽吸系统联合支架置入术后,左侧锁骨下静脉及腋静脉血流恢复通畅。术中患者无胸闷憋喘等并症状及其他并发症。术后口服拜瑞妥治疗。6个月随访,患者左侧上肢肿胀较前减轻,超声检查左侧深静脉血流通畅。结论:AngioJet血栓抽吸系统联合支架置入术适用于上肢深静脉血栓的治疗。
Objective: To summarize the effectiveness of AngioJet thrombectomy system combined with stenting in the treatment of deep venous thrombosis of upper extremities. METHODS: With the help of superficial venous angiography, the left elbow transverse stripes were punctured in the brachial vein to open the occlusion of the subclavian vein, then the AngioJet thrombus aspiration catheter was delivered along the guide wire. The left subclavian vein - Venous thrombus area for urokinase intracavity injection. Repeated aspiration after venography still visible significant residual stenosis, placed in the left subclavian vein Wallstent stent 1, the expansion after the balloon dilatation, expansion after angiography see the left subclavian vein to restore patency, no significant residual stenosis, angiography No spill and retention. Results: The patient’s operation time was 111min, the amount of bleeding during operation was 10ml. Patients underwent angioJet thrombectomy system stent implantation, left subclavian vein and axillary vein flow patency. No intraoperative chest tightness, wheezing and other symptoms and other complications. Postoperative oral Xarelto treatment. After 6 months of follow-up, the left upper extremity swelled less than before, and left venous blood flow was unobstructed by ultrasound. Conclusion: AngioJet thrombectomy system combined with stent implantation for upper extremity deep vein thrombosis treatment.