E nānā pono i ka pae o ka thrombus elimination

ʻO ka thrombectomy ʻokiʻoki he ala e hiki ke wehe koke i ka thrombus i ka manawa pōkole.Ma hope o ka hoʻomaʻemaʻe ʻia ʻana o ka thrombus, e hoʻi hou ka vein i hoʻopaʻa ʻia i ka patency, a hiki ke loaʻa kahi prognosis lōʻihi maikaʻi loa ma ka hoʻomaʻemaʻe ʻana i ka thrombus ma o ke kaʻina.Ma muli o ka ʻeha nui, ke koko a me nā pilikia o ka ʻoki ʻana, ʻaʻole nui nā halemai e hana ana i ka noiʻi lapaʻau.

I nā makahiki i hala iho nei, ʻo ka hoʻohana ʻana i nā lāʻau thrombolytic a me ka hoʻomohala wikiwiki ʻana o ka ʻenehana intravascular e hoʻokumu i ka manaʻo o "thrombus clearance".Ma ke kumu o ka anticoagulation therapy, hiki ke noʻonoʻo ʻia ka thrombolytic therapy ma ke ʻano he koho hoʻolālā ikaika a maikaʻi hoʻi, i kūpono no nā maʻi DVT i haʻalele i nā contraindications thrombolytic.

I kēia manawa, ʻo urokinase (UK) a me alteplase ka mea maʻamau i hoʻohana ʻia i nā mea fibrinolytic ma DVT clinical thrombolytic therapy ma ka home a ma waho.Hiki i ka thrombolytic therapy ke hoʻonui i ka thrombolytic recanalization, pale i ka hana valve, hoʻemi i ka hopena o PTS, a me ka hoʻomaikaʻi ʻana i ka maikaʻi o ke ola o nā maʻi e pili pono ana i ke kiʻekiʻe o ka thrombolysis.Hiki ke hoʻokaʻawale ʻia ka lāʻau thrombolytic i peripheral venous thrombolysis (systemic thrombolysis) a me ka catheter directed thrombolysis (CDT).

Me ka hoʻomaikaʻi ʻana o nā mea hana a me ka ʻenehana, loaʻa ka CDT i nā pōmaikaʻi i ka mālama ʻana i ka DVT.Hoʻopili pololei ia i ka thrombus kūloko me nā lāʻau thrombolytic, kahi e hoʻonui nui ai i ka neʻe ʻana o nā lāʻau thrombolytic a puni ka thrombus.ʻOi aku ka nui o ka wahi pili ma waena o nā lāʻau thrombolytic a me ka thrombus ma mua o ka thrombolysis venous peripheral.Hoʻonui nui ka lāʻau CDT i ka nui o nā lāʻau e hana ana i ka thrombus, hoʻonui nui i ka helu recanalization vascular ma hope o ka thrombolysis, a ʻoi aku ka maikaʻi o ka hopena curative ma mua o ka peripheral venous thrombolysis.

Ua lilo ʻo CDT i ke ʻano thrombolytic maʻamau i hoʻohana ʻia i kēia manawa, hiki ke hōʻemi pono i nā pilikia o ke koko i ka wā e wikiwiki ana i ka thrombolysis.ʻO ka lāʻau lapaʻau mechanical thrombectomy (PMCT) he mea ia me ka hoʻololi ʻana ma ka hopena o ke poʻo, hiki ke ʻoki i ka thrombus a omo i loko o ka catheter ma o ke kaomi ʻino, a laila hui pū me CDT kuʻuna, hiki ke hōʻemi i ka nui o nā lāʻau thrombolytic a me ka manawa lapaʻau ma kahi o kahi. 50%.

Ua like ka hopena thrombus clearance o PMCT a me CDT, akā ʻoi aku ka palekana o ka PMCT, hoʻolalelale i ka thrombus recanalization, hoʻemi i ka manawa mālama, hoʻemi i ka hoʻohana ʻana i nā lāʻau thrombolytic a me nā pilikia koko, hoʻemi i ka hanana o PTS, hoʻemi i ka helu o nā lā ma ka haukapila a hoʻemi i ka koina o ka halemai.

ʻO ke aʻo ʻana ʻo Cavent kahi haʻawina i hoʻopaʻa ʻia i ka lāʻau anticoagulant maʻamau i hui pū ʻia me CDT a me ka lāʻau anticoagulant maʻamau i ka thrombosis iliofemoral deep vein thrombosis, nāna i kiʻi i nā maʻi mai nā halemai 20 ma Northwest Norway.

Hōʻike nā hopena o kēia haʻawina e hoʻohālikelike ʻia me ka lāʻau anticoagulant wale nō, hiki i ka hui CDT therapy ke hoʻemi nui i ka pilikia o PTS, akā hoʻonui iki i ka pilikia o ke koko.Eia naʻe, ke hoʻohālikelike ʻia me ka systemic thrombolysis, ʻae ʻia kēia pilikia o ke koko.

Kākoʻo kēia hopena i ka ʻōlelo aʻoaʻo o nā alakaʻi hou e hiki ke noʻonoʻo ʻia ka mālama ʻana i ka CDT i nā maʻi me ka thrombosis vein hohonu proximal a me ke koko haʻahaʻa.