摘要
目的评价AngioJet机械血栓清除系统联合置管溶栓(CDT)治疗急性肾动脉栓塞(RAE)的效果。方法回顾性分析2016年1月至2018年6月苏州大学附属第一医院收治的8例急性RAE患者临床资料。所有患者治疗前均经腹部增强CT明确诊断,急诊接受AngioJet机械血栓清除系统抽栓联合CDT治疗,溶栓后24 h复查DSA造影,肾动脉主干及分支血流恢复满意后拔除溶栓导管,否则继续溶栓至48 h,复查造影后拔除溶栓导管。住院期间及出院后均予抗凝治疗,观察出院后1、3、6个月门诊随访结果。结果 8例患者均成功完成AngioJet机械血栓抽吸治疗,复查造影显示肾动脉主干完全再通,肾动脉主要分支仍可见充盈缺损;CDT 24 h后无明显血栓残留和狭窄,拔除溶栓导管。24 h内患者腰痛或腹痛症状明显缓解,住院期间未发生肾脏坏死、脏器出血、死亡等严重并发症。随访至6个月时患者肾动脉血流通畅、肾功能正常。结论 AngioJet机械抽栓联合CDT可迅速清除肾动脉主干及其主要分支动脉血栓形成,快速恢复肾脏血供,治疗急性RAE具有良好的安全性和有效性。
Objective To evaluate the efficacy of AngioJet mechanical thrombus aspiration system combined with catheter-directed thrombolysis(CDT) in treating acute renal artery embolism(RAE). Methods The clinical data of 8 patients with RAE, who were admitted to the First Affiliated Hospital of Soochow University of China during the period from January 2016 to June 2018 to receive treatment, were retrospectively analyzed. The diagnosis was confirmed by preoperative abdominal contrast-enhanced CT scan and emergency AngioJet mechanical thrombus aspiration system combined with CDT was carried out in all patients. Twenty-four hours after CDT reexamination of DSA was performed to assess the blood flow in the main renal artery and its branches, the thrombolytic catheter was retrieved if the blood flow recovered satisfactorily, otherwise CDT was kept on for 48 hours and thrombolytic catheter was retrieved after reexamination of angiography. Anticoagulant therapy was adopted during hospitalization and after discharge. Patients were regularly followed up at 1, 3, and 6 months after treatment. Results AngioJet mechanical thrombus aspiration treatment was successfully accomplished in all 8 patients. Reexamination with DSA showed that complete recanalization of main renal artery was achieved, although filling defect in the main branches of the renal artery could still be observed. Twenty-four hours after CDT, no obvious thrombus residue or arterial stenosis were seen and the thrombolytic catheter was retrieved. The symptoms of back pain and abdominal pain were remarkably improved within 24 hours after CDT. During hospitalization period, no serious complications such as renal necrosis, organ hemorrhage or death occurred. Follow-up check at 6 months after treatment indicated that the renal artery was unobstructed and the renal function was normal. Conclusion AngioJet mechanical thrombus aspiration system combined with CDT can rapidly remove the thrombus in the main renal artery and its main branches and quickly recover the renal blood supply. Therefore, this therapy is safe and effective for the treatment of acute RAE.
作者
徐一丁
蔡旭升
杨超
王孝运
倪才方
段鹏飞
XU Yiding;CAI Xusheng;YANG Chao;WANG Xiaoyun;NI Caifang;DUAN Pengfei(Department of Interventional Vascular Surgery,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China)
出处
《介入放射学杂志》
CSCD
北大核心
2020年第4期389-392,共4页
Journal of Interventional Radiology
作者简介
通信作者:段鹏飞,E-mail:dpf621@126.com;通信作者:杨超,E-mail:yangchaojr@163.com。
