摘要
目的探讨应用Indigo机械负压抽吸导管治疗急性肠系膜上动脉血栓病变的有效性和安全性。方法回顾性分析2023年4月至2024年4月行Indigo机械负压抽吸导管治疗的7例急性肠系膜上动脉血栓病变患者的临床资料,均经增强CT确诊急性肠系膜上动脉栓塞或血栓形成。均行股动脉穿刺,采用8F Indigo机械负压抽吸导管清除肠系膜上动脉内血栓,其中联合行球囊扩张成形术3例,支架成形术1例。结果本组7例患者共行8次腔内手术,其中1例行二次Indigo机械负压抽吸+球囊扩张成形术,总体技术成功率为100%。6例(次)手术血栓达到完全清除,2例(次)血栓部分清除。术后所有患者腹痛症状均有所缓解,无靶血管破裂出血、穿刺点出血等手术相关并发症发生。2例患者行小肠部分切除及肠吻合术,其余患者肠功能恢复良好,顺利出院。所有患者均获有效随访,随访时间6~12个月。除1例患者首次手术后1个月症状复发行而二次手术外,余均未复发,随访期间无患者死亡。结论Indigo机械负压抽吸导管创伤小,能够有效清除急性肠系膜上动脉血栓,临床应用安全,及早应用可以避免肠缺血坏死。
Objective To investigate the safety and efficacy of Indigo mechanical aspiration catheter in the treatment of acute superior mesenteric artery(SMA)embolism and thrombosis.Methods The clinical data of seven patients with acute superior mesenteric ischemia managed by Indigo mechanical aspiration catheter in our center from April 2023 to April 2024 were retrospectively analyzed.Acute SMA embolism or thrombosis was confirmed by contrast-enhanced CT in all cases.Access was established via the femoral artery,and aspiration of emboli was performed in SMA with an 8F Indigo catheter,including three cases combined with balloon dilatation and one case combined with stent angioplasty.Results A total of eight endovascular operations were conducted in seven cases.Of which,one case received secondary operation of Indigo mechanical aspiration combined with balloon dilatation,and the total technical success rate was 100%.The emboli were completely removed in six operations and partially removed in two operations.The symptom of abdominal pain was relieved in all cases after the operation,and no operation-related complications such as hemorrhage of target vessel rupture and puncture point occurred.Two cases underwent partial small bowel resection and intestinal anastomosis due to intestinal necrosis,while the remaining cases recovered well and were successfully discharged.All cases were effectively followed up for 6 to 12 months.There was no recurrence except for one case who underwent secondary surgery due to recurrence of mesenteric ischemia symptoms one month after the first operation,and no one died during the follow-up period.Conclusions Endovascular emboli aspiration with Indigo mechanical aspiration catheter is a mini-invasive,safe and effective technique for treating acute SMA embolism or thrombosis.Early application of this technique can effectively prevent intestinal ischemic necrosis.
作者
张喆
连利珊
冯海
陈学明
ZHANG Zhe;LIAN Lishan;FENG Hai;CHEN Xueming(Department of Vascular Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中国现代手术学杂志》
2024年第5期375-379,共5页
Chinese Journal of Modern Operative Surgery
关键词
肠系膜上动脉
血栓栓塞
血栓形成
机械负压抽吸导管
superior mesenteric artery
thromboembolism
thrombosis
mechanical aspiration catheter
作者简介
通信作者:张喆,邮箱:zzcums@hotmail.com。
