对于急性下肢深静脉血栓的早期血栓切除:关于包括,技术方面和术后管理的更新
Adam N Plotnik1,2, Zachary Haber3,4, Stephen Kee3,4
1Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 2125, Los Angeles, CA, 90095, USA. aplotnik@mednet.ucla.edu.
Cardiovascular and interventional radiology
|November 14, 2024
概括
血管内干预为急性深静脉血栓症 (DVT) 提供了抗凝药的替代方案,旨在改善血栓分离并降低血栓后综合征风险.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 心血管医学 心血管医学
背景情况:
- 急性下肢深静脉血栓塞 (DVT) 导致显著的发病率,包括疼痛,胀和肺栓塞 (PE) 的风险.
- 标准的抗凝治疗可能导致不完全的DVT解脱,增加复发性静脉血栓栓塞 (VTE) 和血栓后综合征 (PTS) 的风险.
研究的目的:
- 讨论下肢病例内血管DVT干预的技术因素和当前问题.
- 为患者选择,抗凝策略和内血管血栓去除器件选择提供见解.
主要方法:
- 审查目前的内血管DVT干预技术,包括导管导向血栓溶解,药物机械血栓切除和机械血栓切除.
- 讨论关键的技术方面,如患者选择,抗凝管理,设备选择,辅助疗法和静脉支架放置.
主要成果:
- 内血管干预为DVT管理提供了一个替代的治疗策略.
- 优化技术因素对于成功的DVT解析和最大限度地减少长期并发症至关重要.
结论:
- 内血管DVT干预需要仔细考虑患者选择,抗凝剂和设备选择,以获得最佳的结果.
- 解决内血管DVT治疗的技术挑战可以改善血栓的分离,并减少PTS和复发性VTE的发生率.
相关概念视频
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
623
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
623
01:15Veins of Lower Limbs
650
The human body consists of an intricate network of veins responsible for the crucial task of blood drainage from the lower limbs. These veins can be categorized into two main types: deep veins and superficial veins.
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the...
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the...
650
01:16Clot Retraction and Fibrinolysis
4.2K
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
4.2K
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
365
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
365
01:28Esophageal Varices-II: Clinical Features and Management
46
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
46
01:18Endocarditis III: Medical Management
2
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
2