急性肺动脉栓塞及进展心内科何国祥讲解课件.ppt

* Abstract Objectives: To evaluate the feasibility and efficacy of the retrievable G¨unther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter’s implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20–42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable G¨unther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The G¨unther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable G¨unther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications. ? 2007 Elsevier Ireland Ltd. All rights reserved. * Treatment Strategy for Acute Pulmonary Artery Embolism * Conclusions Catheter-based therapy for massive PE can be a lifesaving therapy. There are no large-scale studies examining this treatment modality, but available data suggest that hemodynamic stability can be restored in 86.5% of patients. In the absence of systemic thrombolysis, the rate of major and minor periprocedural complications can be as low as 10%.7 Our current experience comes mostly from single-center, retrospective series and selected patients, but high mortality and morbidity associated with massive PE make this therapy an attractive alternative. Unlike surgical embolectomy, percutaneous interventions can be instituted rapidly and widely because most hospitals are e