Pharmacomechanical thrombectomy of acute deep vein thrombosis with the Trellis-8 isolated thrombolysis catheter
Pharmacomechanical thrombectomy of acute deep vein thrombosis with the Trellis-8 isolated thrombolysis catheter
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DOI：
10.1016/j.jvir.2007.03.013
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发表时间：
2007-06-01
影响因子：
2.9
通讯作者：
Kee, Stephen T.
中科院分区：
文献类型：
--
作者：
O'Sullivan, Gerard J.;Lohan, Derek G.;Kee, Stephen T.
目得：评价Trellis-8隔离溶栓导管在单次药物机械血栓切除术（PMT）联合低剂量组织纤溶酶原激活剂（TPA）溶栓治疗急性深静脉血栓形成（DVT）和多种合并症患者期间的性能。材料和方法：对19例连续的急性膝上DVT患者进行了回顾性分析，这些患者在接受静脉血管成形术和支架置入术后使用Trellis器械进行PMT治疗。所有患者均采用小剂量TPA单独溶栓治疗。伴随治疗包括可回收下腔静脉滤器插入（n = 4）。主要终点是快速静脉血流的恢复;次要终点是血栓清除率。结果：所有病例均实现了快速静脉血流的恢复;血栓清除率低于50%的1例（4%），50%-95%的18例（82%），至少95%的3例（14%）。TPA的中位给药剂量为每例患者13.4 mg。平均治疗时间为91分钟/肢体（范围：61-129分钟），平均21分钟/血栓形成节段（范围：8-31分钟）。无严重并发症。治疗后第2天静脉段的一期通畅率为86%（n = 19），第30天的一期辅助通畅率为100%。结论：Trellis系统是治疗急性DVT的有效方法。根据现有数据，可以证明Trellis系统是一种安全可行的单次PMT方法，可用于治疗更广泛患者人群中的急性DVT，并需要在大规模研究中进行进一步研究。
PURPOSE: To evaluate the performance of the Trellis-8 isolated thrombolysis catheter during single-session pharmacomechanical thrombectomy (PMT) combined with low-dose thrombolysis with tissue plasminogen activator (TPA) in the treatment of patients with acute deep vein thrombosis (DVT) and multiple comorbidities.MATERIALS AND METHODS: Retrospective analysis was performed of 19 consecutive patients with acute above-knee DVT treated by PMT with the Trellis device followed by venous angioplasty and stent placement. Isolated thrombolysis with low-dose TPA was used with all patients. Concurrent therapies included retrievable inferior vena cava filter insertion (n = 4). The primary endpoint was restoration of rapid inline venous flow; the secondary endpoint was thrombus clearance.RESULTS: Restoration of rapid inline venous flow was achieved in all cases; thrombus removal was less than 50% in one case (4%), 50%-95% in 18 cases (82%), and at least 95% in three cases (14%). The median administered dose of TPA was 13.4 mg per patient. The mean treatment time was 91 minutes per limb (range, 61-129 min), with a mean of 21 minutes per thrombosed segment (range, 8-31 min). There were no major complications. Primary patency rate of the treated venous segments at 2 days was 86% (n = 19) and the primary assisted patency rate was 100% at 30 days. Two patients died of advanced malignancy at 17 and 24 days.CONCLUSIONS: The Trellis system was an effective method for the treatment of acute DVT. Based on the present data, the Trellis system could prove to be a safe and feasible single-session PMT method for the treatment of acute DVT in a broader patient population and warrants further investigation in a large-scale study.