【摘要】 目的:探讨左下肢深静脉血栓(LEDVT)导管溶栓治疗(CDT)中,常用插管技术失败情况下采用辅助性插管技术的应用价值。方法:对采用经右股静脉或/和右侧颈静脉等常用技术途径插管失败的35例LEDVT患者,6例采用同轴插管技术、8例采用翻山鞘技术、19例采用左(患)侧股静脉插管技术、2例采用微导管技术等4种辅助性插管技术。结果:同轴插管技术,插管成功率83.33%(5/6),翻山鞘技术:插管成功率75.00%(6/8),(患)侧股静脉插管技术:插管成功率89.47%(17/19)。微导管技术:插管成功率100%(2/2);四种方法总插管成功率85.71%(30/35)。经过3～14天导管溶栓治疗后血栓均基本溶解,下肢肿胀消退,未发生与插管有关的严重并发症。结论:本研究初步表明,LEDVT导管溶栓治疗中,在常用技术插管失败情况下,上述辅助性插管技术的应用是安全、有效的,能有效提高插管的成功率。更多还原

【Abstract】 Objective:To investigate the feasibility of assistant catheterization in interventional treatment of deep venous thrombosis of left lower extremity(LEDVT) after routine catheterization failed.Methods:In 35 patients with acute deep thrombosis of left lower extremity who failed in left iliac-femoral catheterization via the right femoral vein or the right jugular vein access,co-axial catheterization was performed in 6 patients(Method 1)."Crosses sheath" techniques were performed in 8 patients(Method 2).Bilateral femoral vein approaches were performed in 19 patients(Method 3).Microcatheter was used in 2 patients(Method 4).Results:5 cases succeed in Method 1(5/6,83.3%),6 cases succeed in Method 2(6/8,75%),16 cases succeed in Method 3(17/19,89.47%),2 cases succeed in Method 4(2/2,100%).The total success rate is 85.71%(30/35).Catheter thrombolysis was employed for 3 to 14 days.the thrombosis was completely dissolved and the lower extremity swelling subsided there were not serious complications.Conclusion:Our preliminary rusults indicates that the assistant techniques,including co-axial catheterizations,"crosses sheath",bilateral femoral vein approaches and microcatheter are safe and effective methods which can reliably help the successful performance of catheterization,it can be safely used in complex cases when routine catheterization fails.更多还原