Cockett综合征的介入治疗

Interventional treatment of Cockett syndrome

目的探讨Cockett综合征(CS)的有效治疗方法。方法回顾性分析2004年8月至2011年10月收治的25例CS的病例资料。结果左髂总静脉压迫24例,其中23例合并急性下肢深静脉血栓形成(DVT),1例为左下肢深静脉血流减慢;右髂外静脉压迫1例,为下肢深静脉血流减慢。合并DVT患者,首先行下腔静脉滤器置入术、左股静脉切开取栓术,后行髂总静脉经皮腔内血管成形术(PTA),根据PTA术后造影结果决定是否行支架置入术;未合并DVT患者,经股静脉穿刺行髂静脉PTA术和支架置入术。手术成功率100%。22例术后恢复良好,3例患者出院时肢体轻度肿胀。18例获得随访,随访时间1个月至5年(平均26个月),3例出现活动后下肢肿胀,余15例下肢无肿胀,无静脉曲张;随访患者均行彩超检查,2例髂静脉闭塞,16例髂静脉通畅,通畅率为88.9%。结论介入治疗CS可获得满意疗效。

Objective To explore the effective treatment of Cockett syndrome (CS). Methods The clinical data of 25 patients with CS were analyzed retrospectively from August 2004 to October 2011. Results Of the 25 patients, the left common iliac vein was compressed in 24 cases,.including 23 cases complicated with acute deep venous thrombosis (DVT) of left lower extremity and 1 complicated with deep vein flow reduction..Right common iliac vein compression accompanied with deep vein flow reduction occurred in 1 case. For the patients with CS and acute DVT, inferior vena cava filter placement and thrombectomy of the left femoral vein were performed at first,.then percutaneous transluminal angioplasty(PTA)was done. PTA results decided whether stent implantation of the common iliac vein was performed..For the 2 patients with CS and without DVT, PTA and stent implantation of the iliac vein was done. Successful rate of operation was 100%..Twenty-two patients recovered well and 3 patients had slight leg swelling when discharged. Eighteen cases were followed up with a time of 1 months to 5 years.(mean time, 26 months). Of them, 3 patients presented lower limb swelling after walking exercise, and other patients were well..And Duplex ultrasonic examination showed that common iliac vein was obstructed in 2 patients and patent in others,.and patency rate was 88.9%. Conclusion Interventional procedure for CS can receive satisfactory outcomes.