仅使用功率脉冲喷雾进行辅助血块碎片化的单次导管导向溶解是一种急性肺栓塞的快速,安全和有效的选择
Laurencia Villalba1, Raeed Deen2, Brendan Tonson-Older2
1Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia; Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia; Intensive Care Unit, Department of Vascular Surgery, Vascular Care Centre, Wollongong, New South Wales, Australia.
Journal of vascular surgery. Venous and lymphatic disorders
|April 27, 2024
概括
用功率脉冲喷雾 (CDT-PPS) 进行单次导管导向血栓溶解是一种安全有效的高风险和中风险肺栓塞 (PE) 治疗方法. 这种微创手术为PE患者提供了快速缓解症状和优秀的长期康复.
科学领域:
- 心脏病学 心脏病学
- 干预性放射学 干预性放射学
- 肺部医学 肺部医学
背景情况:
- 肺栓塞 (PE) 具有重大风险,特别是在高风险和中等风险病例中.
- 由于出血风险,在许多PE患者中,全身血栓溶解可能是禁忌的.
- 导导管治疗为PE提供局部治疗选择.
研究的目的:
- 评估一次性导管导向血栓溶解与辅助动力脉冲喷雾 (CDT-PPS) 治疗肺栓塞的安全性和有效性.
- 评估临床结果,包括技术成功,重大不良事件和长期康复.
- 确定CDT-PPS在有系统性血栓溶解禁忌的患者中的疗效.
主要方法:
- 对从104名患有高风险或中等风险PE的患者前性收集数据的回顾性分析.
- 没有血栓切除术的单次CDT-PPS手术.
- 评估技术和临床成功,主要不良事件,X光学分辨率,右心室功能,并恢复到病前状态.
主要成果:
- 在98%的患者中取得了技术上的成功.
- 48小时后的生存率为99%,4周后的生存率为96%,12个月后的生存率为91%.
- 在4周内,72%的皮质前列腺完全消失,98%的皮质前列腺没有表现出右心功能障碍,96%的皮质前列腺在12个月后恢复到病前状态.
- 平均ICU和整体停留时间分别为1天和6天,48小时没有重大不良事件.
结论:
- CDT-PPS是一种快速,安全和有效的高风险和中等风险PE治疗方法.
- 这种技术甚至适用于高出血风险的患者.
- 当资源和专业知识可用时,CDT-PPS应被视为一线选择.
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