2011 7 20 7 J Intervent Radiol 2011 Vol.20 No.7 505 Special comment DVT :R654.4 :A :1008-794X(2011)-07-0505-06 The consensus among Chinese interventional experts on the standard of interventional therapy for deep venous thrombosis of lower extremity Academic Group of Interventional Radiology Radiology Branch of Chinese Medical Association Department of Radiology First Affiliated Hospital of Nanjing Medical University Nanjing 210006 China Corresponding Author: GU Jian-ping XU Ke TENG Gao-jun Abstract This paper aims to introduce the indications and contraindications of catheter-directed thrombolysis percutaneous mechanical thrombectomy balloon angioplasty and stent implantation for deep venous thrombosis of lower extremity and also aims to summarize and to illustrate the manipulating procedure the points for attention the perioperative complications and preventions in performing different kind of interventional technique. Great importance is attached to the interventional therapy for both acute and subacute deep venous thrombosis of lower extremity in order to effectively reduce the occurrence of postthrombosis syndrome. (J Intervent Radiol 2011 20: 505-510) Key words Deep venous thrombosis; Interventional therapy; standard (deep venous thrombosis DVT) DVT [3] :1 ;2 (pulmonary embolism PE) DVT PE (venous DVT :1 14 d thromboembolism VTE) DVT ;2 15 ~ 28 d;3 28 d ;4 PTS ;5 (postthrombosis syndrome PTS) [1-2] 1 DVT 1.1 DVT 1.1.2 (1) DVT; (2) 1.2 DVT 1960 Greenfield X 1984 Sniderman [4] 1.1.1 1 : DVT;2 : ;3 DVT DVT (PTA) DVT : (2007BAI05B04) 4 1 : :210006 ); ) )
506 2011 7 20 7 J Intervent Radiol 2011 Vol.20 No.7 2 : DVT Homan Neuhof 3.2 3 : DVT D- (D-D) : (ELISA) D-D > 500 μg / L ; DVT : (PT) (INR) DVT PTA (FIB) (APTT) 4 : (TT) 6 3.3 [5-11] DVT 3.3.1 2 [81012-13] 2.1 2.1.1 1 DVT; 2 DVT; 3DVT 3.3.2 2.1.2 13 ) DVT 1 ; DVT 2 ; 3-3.3.3 DVT DVT ;4 > 180 / 110 mmhg);575 [14-15] 2.2 (MSCTA) DVT 2.2.1 1 DVT;2 3.3.5 MRA MRA 2.2.2 1 DVT; 2 DVT; 3 [16-18] 2.3 PTA 2.3.1 1 (Cockett May-Thurner );2 ;3 [24] ;4 PTA) 4 2.3.2 1 ;2 4.1 ;3 4.1.1 3 3.1 ; 3.3.4 CTA CT [19-21] [22] ) 4 ~ 7 3.8 [23] 3.9 20 ~ 100 u / d 7 d 4.1.1.1 : 1 [25-26] ;2
2011 7 20 7 J Intervent Radiol 2011 Vol.20 No.7 507 4.1.1.2 : 1 2 4.2.1.3 [27] [1128] 4.1.1.3 :1 2 4.2.1.4 ; 4.1.2 4.1.2.1 : 8 ~ 12 F 4.2.2 50 ml 30 ml 4.2.2.1 : 1 4.1.2.2 : 7 ~ 8 F 4 ~ 5 F 200 ml 3 DVT 4 > 30% 5 4.1.3 PTA 4.1.3.1 PTA:1 2 4.2.2.2 :1 DVT 3 2 10 ~ 12 mm ; 8 ~ 10 mm 4 4.2.3 PTA 1 ~ 3 min 4.2.3.1 DVT [29-31] 4.1.3.2 :1 2 12 ~ 14 mm 4.2.3.2 3 10 ~ 12 mm 4.2 4.2.1 4.2.1.1 3 mm ; [17-1829] 4.2.3.4 2 4.2.3.3 1 ~ 2 mm 4.2.3.5 ) 4.2.1.2 DVT )
508 2011 7 20 7 J Intervent Radiol 2011 Vol.20 No.7 4.3 4.3.1 4.4.4 PE PTA PTA 30 cm 20 PE 4.3.2 2 ~ 3 d PE PTA 4.3.3 4.4.5 PTA PTA 4.3.4 6 DVT 1 3 6 12 ;6 12 PTA ; PTA 1 4.5 4.4 4.4.1 DVT [35] CT DVT DVT 6 1 3 4 : PE DVT 1.0 cm 4.4.2 : 1.0 ~ 1.5 cm : 1.5 cm < 1.5 ~ 2.0 cm : 3 [32-34] > 2.0 cm [1736] 4.4.3 5 DVT DVT ; DVT 3 ~ 7 d
2011 7 20 7 J Intervent Radiol 2011 Vol.20 No.7 509 DVT [9] Grunwald MR Hofmann LV. Comparison of urokinasealteplase and reteplase for catheter-directed thrombolysis of deep venous thrombosis[j]. J Vasc Interv Radiol 2004 15: 347-352. : [10] Mewissen MW Seabrook GR Meissner MH et al. Catheterdirected thrombolysis for lower extremity deep venous thrombosis: ); ); report of a national multicenter registry [J]. Radiology 1999 ); 211: 39-49. [11]. ); [J]. 2000 9: 206-209. ); [12] Gogalniceanu P Johnston CJ Khalid U et al. Indications for ); thrombolysis in deep venous thrombosis[j]. Eur J Vasc Endovasc ); Surg 2009 38: 192-198. [13]. ); [J]. 2003 37: 33-36. ); [14]. - [M]. ); : 2005 376-386. ); [15]. Amplatz ); [J]. 2003 37: 727-731. [16]. [M]. : ); 2004 398-405. ); [17]. ); [J]. 2008 42: 821-825. ); [18]. ); ) [J]. 2008 17: 22-25.. 16 [ ] [1]. [M]. : 2007: 111-114. - 952. [2]. ). : [21]. CT [G]. [J]. 2009 : 2004: 50-56. [3]. [22]. MR [M]. : 2004 320-329. DSA [J]. [4] Sniderman KW Bodner L Saddekni S et al. Percutaneous 2007 41: 1193-1195. embolectomy by transcatheter aspiration. Radiology 1984 150: 357-361. Work in progress [J]. [5] Gasparis AP Labropoulos N Tassiopoulos AK et al. Midterm follow-up after pharmacomechanical thrombolysis for lower extremity deep venous thrombosis [J]. Vasc Endovascular Surg 2009 43: 61-68. [6] Smalberg JH Spaander MV Jie KS et al. Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis [J]. Thromb Haemost 2008 100: 1084-1088. [7] Martinez Trabal JL Comerota AJ LaPorte FB et al. The quantitative benefit of isolated segmental pharmacomechanical thrombolysis (ISPMT) for iliofemoral venous thrombosis [J]. J Vasc Surg 2008 48: 1532-1537. [8] Kim HS Preece SR Black JH et al. Safety of catheter-directed thrombolysis for deep venous thrombosis in cancer patients [J]. J Vasc Surg 2008 47: 388-394. [19] CT [J]. 2004 38: 1164-1168. [20]. CT [J]. 2009 43: 948 43: 1156-1159. [23]. [J]. 2004 38: 397-401. [24]. [J]. 2011 45: 297-300. [25]. [J]. 2005 39: 921-924. [26]. [J]. 2008 17: 15-18. [27]. - [J]. 2001 35: 768-771. [28]. [J]. 2002 225-227. [29] Lou WSh Gu JP He X et al. Endovascular treatment for iliac vein compression syndrome: a comparison between the presence and absence of secondary thrombosis [J]. Korean J Radiol
510 2011 7 20 7 J Intervent Radiol 2011 Vol.20 No.7 2009 10: 135-143. [30] Vedantham S Vessely TM Sicard GA et al.pharmacomechanical thrombolysis and early stent placement for iliofemoral deep vein thrombosis[j]. J Vasc Interv Radiol 2004 15: 565-574. [31] O Sullivar GJ Semba CP Bittner CA et al. Endovascular management of iliac vein compression (May-thurner) syndrome [J]. J Vasc Interv Radiol 2000 11: 823-836. [32] Savader SJ Trerotola SO. Venous interventional radiology with clinical perspectives[m]. New York Sluttgart: Thieme 2nd ed. 2000 458-466. [33] Fisoli JK Sze D. Mechanical thrombectomy for the treatment of lower extremity deep vein thrombosis [J]. Radiol 2003 6: 49-52. Tech Vasc Interv [34] Sharafuddin MJ Gu X Han YM et al. Injury potential to venous valves from the Amplatz thrombectomy device[j]. J Vasc Interv Radiol 1999 10: 64-69. [35]. Abrams [M]. : 2010 1012-1021.. 2. [36]. 576 [J]. 2006 26: 1261-1264. :2011-04-12)!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Case report ; ; :R543.1 :D :1008-794X(2011)-07-0510-03 Endovascular exclusion with double-chimney technology for treating aortic arch pathologies FENG Rui JING Zai-ping ZHAO Zhi-qing WEI Xiao-long LU Hua WANG Liang. Department of Vascular Surgery Changhai Hospital Second Military Medical University; Institute of Vascular Surgery of PLA Shanghai 200433 China Corresponding author: JING Zai-ping E-mail: jingzp@xueguan.net Key words aortic; endo vascular exclusion; double-chimney technology (endovascular exclusion EVE) CT Stanford B 2 cm ; 6 cm [12] EVE ; 1 EVE CT 2.1 cm EVE 12 mm 1 1.1 EVE 1.1 36 8 - (stent-graft SG) 1) : (30873077); 12 h 6 CT (06G58) :200433 SG 2) : E-mail: jingzp@xueguan.net 1.1.2 (SINUS OptiMed Medical