坎伯兰医院Ekos溶栓治疗髂股静脉血栓

M. B, N. I., Eifell R, Cusso M, Barakat T, Babikir S, Taran D, M. C., Ojimba T, Naqvi S
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引用次数: 0

摘要

静脉血栓栓塞是影响下肢的常见血管疾病,由DVT(2/3的VTE)和PE(1/3的VTE)组成。DVT治疗的目标是预防PE、复发或PTS,抗凝治疗是预防PE或复发DVT治疗的基石。目的:回顾我们在Cumberland医院的经验,评估EKOS®溶栓治疗髂股深静脉血栓的疗效,重点关注临床结果和任何术后并发症。结果:在Cumberland医院,7年内有22例下肢深静脉血栓溶栓治疗(女16例,男5例),中位年龄20-89岁。治疗总次数;1次:18.18% (n=4), 2次:54.54% (n=12), 3次:22.73% (n=5), 4次:04.55% (n=1)。成功率大于80%:90.91.7% (n=20)。需要进一步手术的患者中,支架置入占77.27 (n=17),血管成形术占36.36% (n=8)。结果;症状改善者占90.91% (n=20),腿部溃疡愈合者占9.52% (n=2)。术后并发症:腿部肿胀28.6% (n=6)均为6周内短期消退,仅有一例长时间站立腿部肿胀。术后腿部疼痛发生率为19.04% (n=4)。9.52% (n=2)的患者存在持续性腿部溃疡和PTS问题。1例复发。无PE/颅内出血。结论:与常规CDT或单独抗凝相比,EKOS可有效治疗急性髂股DVT,停药时通畅率达80%以上,并可预防DVT相关的长期并发症(复发- pe和PTS)。
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Ekos Thrombolysis for The Management of Ilio-Femoral Dvt at Cumberland Infirmary
Introduction: Venous-thromboembolism is common vascular disease affecting lower limbs composed of DVT (2/3 of VTE) and PE (1/3 of VTE). The goal of management of DVT is to prevent PE, recurrence or PTS .Anticoagulation was the cornerstone of DVT management to prevent PE or recurrent DVT. Aim: To review our experience and assess efficacy of EKOS® thrombolysis in management of ilio-femoral DVT at Cumberland infirmary focusing on clinical outcome and any post procedure complications. Results: 22 patients had thrombolysis for illiofemoral DVT over 7years in Cumberland infirmary (Females 16 Males 5). Median age 20-89 years. Total number of treatment Sessions; 1 session: 18.18% (n=4), 2 Session: 54.54% (n=12), 3 sessions: 22.73% (n=5), 4 sessions: 04.55% (n=1). Success rate more than 80%: 90.91.7 % (n=20). Further procedures needed, Stents placement %77.27 (n=17), angioplasty 36.36% (n=8). Outcome; Improvement of symptoms in 90.91% % (n=20) leg ulcer healed in 9.52% (n=2). Post procedure complications: Leg swelling 28.6% (n=6) all are short terms resolved within six weeks and just one long standing leg swelling. Post procedure leg pain is in 19.04% (n=4). Ongoing issues were in 9.52% (n=2) and were persistent leg ulcer and PTS in each. One patient had recurrence. No patient had PE/ intracranial bleeding. Conclusion: EKOS is effective in treating acute ilio-femoral DVT with patency at 80% and more at the cessation of treatment, as well as prevention of DVT related long term complication (recurrence-PE and PTS) in comparison of conventional CDT or anticoagulation alone.
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