大孔吸血血栓切除术对中等或高风险肺栓塞的有效性和安全性
Younes Jahangiri1, James J Morrison2, Myles L Mowery1
1Corewell Health Interventional Radiology, Michigan State University, Grand Rapids, Michigan.
Journal of vascular and interventional radiology : JVIR
|December 31, 2023
概括
大孔机械血栓切除术有效降低中高风险肺栓塞 (PE) 患者的肺动脉压力. 这种安全的手术是有前途的,尽管高血栓切除术后的压力可能表明死亡风险.
科学领域:
- 心脏病学 心脏病学
- 干预性肺病学 干预性肺病学
- 血管外科 血管外科
背景情况:
- 肺栓塞 (PE) 存在重大风险,特别是在中高风险病例中.
- 与传统方法相比,机械血栓切除术提供了一种不那么侵入性的方法来管理PE.
研究的目的:
- 评估大孔机械血栓切除术对中等或高风险PE的有效性和安全性.
- 确定影响这项干预成功的因素.
主要方法:
- 以Flowtriever系统治疗的257名中等或高风险PE患者的回顾性评估.
- 分析包括线性回归和Kaplan-Meier方法,具有P < .05.05的显著性水平.
主要成果:
- 该程序的技术成功率为100%.
- 肺动脉平均压力 (MPAP) 降低了8 mmHg (P < .0001).
- 2%的即时并发症,2%的30天PE导致的死亡率和6%的全年死亡率.
结论:
- 大孔吸血血栓切除术对于降低中等至高风险PE中PAP的安全和有效.
- 血栓切除术后的MPAP>20 mmHg可以预测高风险患者的PE可归因的死亡率.
相关概念视频
Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Pulmonary Embolism I: Introduction
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...


