对于急性阴茎骨深静脉血栓的内血管血栓切除
Anthony J Comerota1, Clive Kearon2,3, Chu-Shu Gu4,3
1Inova Heart and Vascular Institute, Inova Alexandria Hospital, VA (A.J.C.).
Circulation
|December 28, 2018
概括
在 iliofemoral 深静脉血栓症患者中,药物机械导管血栓溶解 (PCDT) 没有预防血栓后综合征 (PTS). 然而,PCDT降低了PTS的严重程度,改善了生活质量.
科学领域:
- 血管医学
- 干预心脏病学
- 血栓形成研究
背景情况:
- 在此前的ATTRACT试验中,药物机械导管血栓溶解 (PCDT) 在急性近道深静脉血栓症 (DVT) 的预防中是无效的.
- 这项分析专门研究了PCDT对ATTRACT试验队列中的大肠瘤患者的影响.
研究的目的:
- 评估PCDT降低急性DVT患者中PTS发生率和严重性的有效性.
- 评估PCDT对腿部症状,生活质量和复发性静脉血栓栓塞的长期影响.
主要方法:
- 这是一项多中心随机试验,涉及391名急性大脑膜瘤患者.
- 患者被随机分配到PCDT加抗凝剂或单独抗凝剂 (无PCDT).
- 在24个月的随访期内评估结果,包括PTS发生,严重程度得分,症状减轻,生活质量和出血事件.
主要成果:
- 在24个月后,PCDT和非PCDT组之间的PTS发生率没有显著差异 (49%和51%).
- PCDT显著降低了PTS严重性得分 (Villalta和静脉临床严重性得分) 以及中度至重度PTS患者的比例.
- PCDT导致腿部疼痛和胀的短期减少,并改善了静脉疾病特异性生活质量,但没有影响一般生活质量.
- 在不同组中,严重出血和复发性静脉血栓塞的发生率相似.
结论:
- 虽然PCDT不能防止PTS发生,但可以显著降低其严重程度.
- PCDT改善了 iliofemoral DVT 患者的早期腿部症状和长期生活质量.
- 这些发现表明PCDT在治疗大肠垂体瘤中发挥作用,减轻长期的后果,尽管它没有预防PTS发作.
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