ABSTRACT
Objective To evaluate the clinical effect of percutaneous transcatheter renal artery thrombolysis in treating acute renal artery embolism. Methods A total of 23 patients with acute renal artery embolism underwent DSA-guided percutaneous transcatheter renal artery thrombolysis. Continuous urokinase thrombolytic therapy with micro pump was carried out in all patients; renal artery angiography was performed 3 days later; the therapeutic effect was evaluated with imaging manifestations and laboratory tests. Results Postoperative DSA showed that the renal artery was completely open in 21 patients and partially open in 2 patients; the effective rate was 91.3%. After thrombolysis treatment, complete remission of pain, oliguria, hematuria, fever and other symptoms was obtained in 21 cases, and relief of symptoms in 2 cases. Postoperative urine protein, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase isoenzyme MB (CK-MB) and serum creatinine (SCr) levels were obviously decreased. Conclusion For the treatment of acute renal artery embolism, DSA-guided percutaneous transcatheter renal artery thrombolysis is very effective, minimally-invasive and highly-safe.
ABSTRACT
Objective Transcatheter thrombolysis is an important method for early recanalization of acute superior mesenteric venous thrombosis (SMVT), which is conducted mainly through percutaneous transhepatic , transjugular intrahepatic, or superior mesen-teric artery approach .This study is to assess the feasibility , effectiveness and safety of catheter-directed thrombolysis via the superior mesenteric vein and artery for acute SMVT . Methods We retrospectively reviewed 8 cases of acute extensive SMVT treated by tran-scatheter thrombolysis via superior mesenteric vein and artery in our institute .We collected and analyzed the general information , case history, etiology, risk factors, imaging characteristics, treatment procedures, complications, and follow-up data of the patients summa-rized the experience in the treatment of acute extensive SMVT by catheter-directed thrombolysis . Results Technical success was a-chieved with substantial symptoms improvement after thrombolytic therapy in all the cases .The local urokinase infusion via the superior mesenteric artery and vein was performed for (6.13 ±0.83) and (12 ±2.51) d.Four patients required delayed localized bowel resection of (1.63 ±0.48) m, with satisfactory recovery after intensive care and organ function support .Contrast-enhanced CT scan and portogra-phy demonstrated complete thrombus resolution in all the patients before discharged after a hospital stay of (19.25 ±4.89) d.Minor bleeding at the puncture site occurred in 2 cases and sepsis developed in another 2 postoperatively .No recurrence and complications were ob-served during the follow-up of (12.13 ±0.99) mo. Conclusion For acute extensive SMVT , catheter-directed thrombolytic therapy via superior mesenteric vein and artery can accelerate thrombus resolution , stimulate collateral vessel development , reverse extensive intestinal is-chemia, avert bowel resection , localize infarcted bowel segment to pre-vent short bowel syndrome , and effectively speed up the recovery and significantly increase the survival rate of the patients .
ABSTRACT
Objective To discuss the clinical effect of two different routes of thrombolysis for the treatment of acute deep vein thrombosis (DVT).Methods A total of 126 patients with DVT during December 2005 to March 2010 were randomly divided into two groups:(1)transcatheter popliteal vein thrombolysis method (group A);(2)thrombolysis therapy via peripheral vein (group B).The venous patency score and patency improvement were observed by venograms or Duplux.Results After treatment,the reduction rate of edema of leg (0.82?0.14)% and of thigh(0.89?0.07)%,and the venous patency improvement rate (55.41?3.21)% in group A were significantly higer than those in thrombol group B(0.63?0.11)%,(0.57?0.09)%and (32.34?3.77)%,respectively (all P