Clinical study of mechanical thrombus extraction associated with medical treatment in lower extremity thrombosis
YU Xi-xiang1, HUANG Lin-fen1, HU Zhe2, NAN Yi1, CHEN Shan-xi1, SI Tong-guo1, FENG Xiao-feng1, ZHANG Ye-min1
1. The Interventional Department, the Third Affiliated Hospital of Wenzhou Medical College, Wenzhou Zhejiang 325200, China; 2. Department of Radiology, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou Zhejiang 325000, China
Abstract：Objective: To study the safety and clinical therapeutic effect of Oasis catheter thrombolysis and Amplatz Thrombectomy Device(ATD) in the treatment of thrombosis in arteries of lower extremity combining recombinant human tissue-type plasminogen activator(rt-PA) or urokinase(UK). Methods: Practise emergence operations were done with Oasis(12 cases) tube thrombolysis or ATD(6 cases) tube macerate thrombolysis for 18 patients suffering thrombosis of arteries of lower extremity, giving rt-PA thrombolysis (2 cases) and UK thrombolysis(7 cases) for distal end small vessels remaining thrombus. Percutaneous transLuminal angioplasty(PTA) or stenting treatments were done for five segments of ilio-femur arteries in four patients. Among 18 patients, there are 3 iliac arteries, 13 femoral arteries, 1 popliteal artery, and 1 widespread thrombosis including femoral artery, popliteal artery, anterior and posterior tibial artery and ped-artery. Results: Technologic achievement ratio is 100% for the 18 cases. 14 cases completely recanalization immediately after treatment; 4 cases completely recanalization afer continue thrombolysis for 3 to 5days by detaining catheter. In 4 cases with 5 stenosis arteries segments, recanalization rate is 95% after taking transLuminal angioplasty or stents, clinical amelioration rate is 100%. The arteries of all cases remain open after 1～45 months by DSA, B supersound and clinical following up. Without complication of vessels perforation and amputated extremity, only one case of digestive tract bleeding. Conclusion: Mechanical thrombolysis with Oasis or ATD catheters combining rt-PA or UK drugs can rapidly dissolved the thrombus of artery of lower extremity, with high safety and great clinical therapeutic effect. Using PTA and stents assistant treatment can effectively relieve stenosis of arteries, prevent reforming of thrombus and avoid amputation of lower extremity.
2006, Vol. 17 
