中国现代手术学杂志2025，Vol.29Issue(5)：366-371,6.DOI:10.16260/j.cnki.1009-2188.2025.05.003
经膝下深静脉穿刺行机械血栓切除术治疗下肢深静脉血栓
Percutaneous mechanical thrombectomy via the infrapopliteal deep venous approach for lower extremity deep vein thrombosis
张洋 1张志文 1靳磊 1刘钊 1陈学明 1李文睿1
作者信息
- 1. 首都医科大学附属北京友谊医院心血管中心,北京 100050
- 折叠
摘要
Abstract
Objective To investigate the safety,efficacy,and technical advantages of percutaneous mechanical thrombectomy(PMT)via the infrapopliteal deep venous approach for lower extremity deep vein thrombosis(DVT).Methods A retrospective analysis was conducted on 22 patients with lower extremity DVT who underwent PMT via the infrapopliteal deep venous approach between April 2022 and June 2024.Among them,15 cases involved the left lower extremity and 7 involved the right.The thrombus involved the in-ferior vena cava in 2 cases,the iliac vein in 15,the femoral vein in 4,and an isolated popliteal vein in 1.Data on the specific punctured vein,time required for infrapopliteal deep venous access,thrombus clearance,and procedure-related complications were recorded.Follow-up venous patency was assessed by ultrasound.Results The infrapopliteal venous access was successfully established via the peroneal vein in 17 cases(77.3%),the posterior tibial vein in2 cases(9.1%),and the anterior tibial vein in 3 cases(13.6%).The mean time required to establish this access was(10.8±5.1)minutes.PMT was technically successful in 21 patients(95.5%).Adjunctive balloon angioplasty was performed in 6 cases and adjunctive catheter-directed thrombolysis(CDT)in 10 cases.The thrombus removal outcome was graded as Mewissen class Ⅱ in 4 cases and class Ⅲ in 17 cases.In these technically successful PMT cases,lower extremity swelling was signifi-cantly alleviated,with limb circumference approaching normal.No procedure-related complications such as hemorrhage or arterial injury occurred.During a follow-up period of 6 to 12 months,residual organized thrombus was observed in 9 patients(40.9%),and no recurrence of lower extremity DVT was observed.Conclusion PMT via the infrapopliteal deep venous approach is a safe,feasible and effective treatment for lower extremity DVT.关键词
下肢深静脉血栓/经皮机械血栓切除术/肺栓塞/胫后静脉/胫前静脉/腓静脉Key words
lower extremity deep vein thrombosis/percutaneous mechanical thrombectomy/pulmonary embolism/posterior tibial vein/anterior tibial vein/peroneal vein引用本文复制引用
张洋,张志文,靳磊,刘钊,陈学明,李文睿..经膝下深静脉穿刺行机械血栓切除术治疗下肢深静脉血栓[J].中国现代手术学杂志,2025,29(5):366-371,6.
