Clinical study of AngioJet thrombectomy for rescue treatment of acute massive pulmonary embolism after unsuccessful thrombolysis: preliminary results
10.3760/cma.j.cn112149-20200909-01072
- VernacularTitle:AngioJet血栓清除术补救溶栓失败的急性大面积肺栓塞初步临床研究
- Author:
Maofeng GONG
1
;
Jianping GU
;
Wensheng LOU
;
Liang CHEN
;
Guoping CHEN
;
Haobo SU
;
Xu HE
Author Information
1. 南京医科大学附属南京医院（南京市第一医院）介入血管科 210006
- Keywords:
Pulmonary embolism;
Urokinase;
Percutaneous mechanical thrombectomy
- From:
Chinese Journal of Radiology
2021;55(8):865-870
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and clinical efficacy of AngioJet pharmacomechanical thrombectomy (APMT) in rescue treatment for patients with acute massive pulmonary embolism (AMPE) after unsuccessful thrombolysis with urokinase (UK).Methods:From June 2016 to June 2018, the clinical data of 16 AMPE patients underwent APMT after unsuccessful thrombolysis with UK were collected. For these patients, the therapy was discontinued and replaced with APMT adjunctive low-dose thrombolysis with UK. Heart rate (HR), systolic blood pressure (SBP), arterial partial pressure of oxygen (PaO 2), pulmonary artery pressure (PAP), CT obstruction index (CTOI) and therapy replacement safety were evaluated. The pared-samples t-test was used to analyze quantitative data before and after treatment. Results:All 16 patients completed APMT procedure. PAP posterior was lower than prior treatment ( P<0.05). The average adjunctive thrombolysis duration of UK was (3.25±1.78) d, HR, SPB, PaO 2 after APMT were significantly improved ( P<0.01). CTOI before and after APMT were (26.81±14.86)% and (11.56±3.26)%, respectively, and the difference was statistically significant ( t=3.435, P<0.01). Symptoms and signs of pulmonary embolism were significantly improved after treatment. The complications associated with APMT occurred in 2 patients with bradyarrhythmia, 2 patients with chest discomfort and 2 patients with hemoglobinuria. There were no statistically significant difference between the biochemistry indexes before and after APMT treatment ( P>0.05). Moreover, no major bleeding occurred during thrombolysis procedure, and minor bleeding complications occurred only in two cases. Conclusions:APMT adjunctive low-dose UK thrombolysis for rescue treatment of AMPE patients after unsuccessful thrombolysis with UK is relatively safe and effective. It can remove pulmonary artery thrombus rapidly, and improve clinical symptoms and signs of PE.
