Objective To evaluate the effectiveness and safety of percutaneous mechanical thrombectomy (PMT) in acute and subacute lower limb ischemia (ALI/SLI) with Straub device. Method Clinical data of 17 cases ALI/SLI admitted in hospital from Jul. 2015 to May 2016 were retrospectively ana-lyzed. All cases were confirmed by Doppler ultrasounography or CTA examination. PMT device (Rotarex, Straub) was navigated to lesions antegradely or retrogradely from femoral artery access. Blood supply im-provement was evaluated intraoperatively by flow angiography. All cases were administrated with antiplatelet or anticoagulation agents after discharged from hospital. After six months follow-up, the effectiveness and safety of therapy were observed. Results Technical success was 94.1%. One case experienced artery rup-ture, and the bleeding was stopped by intraoperative balloon compression. Stent were implanted in 29.4% cases and catheter-directed thrombolysis was performed in 23.5% cases. Symptoms of ischemia were released in all cases. During 6-month follow up, all treated arteries remained patent. Conclusion Treatment of ALI/SLI with PMT device achieves promising clinical outcome, and can be an alternative minimal invasive therapy to traditional thrombectomy.%目的 探讨Rotarex 机械血栓切除系统在治疗急性/亚急性下肢动脉缺血性疾病中的手术疗效.方法 回顾性分析2015年7月至2016年5月经Rotarex 机械血栓切除系统治疗的17例急性/亚急性下肢动脉缺血性疾病的患者资料.患者入院后经下肢动脉彩超或下肢动脉CTA诊断明确,行介入手术治疗,行股动脉顺行或逆行穿刺置管,对下肢动脉病变行经皮血栓切除减容治疗,术中造影评估血运改善情况,术后评估患肢缺血情况,出院后予抗血小板及抗凝治疗,于术后半年进行门诊及彩超复查,评估手术疗效.结果 全部手术患者缺血症状均得到缓解,顺利出院,手术技术成功率94.1%,围术期并发症1例,为血管破裂出血,术中经球囊扩张及外部压迫后止血,支架植入率29.4%,合并置管溶栓治疗23.5%.所有患者获得随访,6个月通畅率100%.结论 对于下肢动脉急性/亚急性下肢动脉缺血性疾病,经皮血栓切除可取得良好效果,是除传统的股动脉切开取栓术外的一种微创新选择.
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