髂静脉压迫综合征并发急性髂-股静脉血栓的腔内治疗

Endovascular management of acute iliofemoral venous thrombosis due to iliac vein compression syndrome

目的:探讨腔内治疗髂静脉压迫综合征并发急性髂-股静脉血栓形成的临床价值。方法:首先在下腔静脉置入滤器后,应用经颈静脉髂-股静脉血栓清除术、PTA和(或)经皮血管内支架置入术等血管腔内治疗技术进行综合性治疗。结果:31例患者经上述治疗后血栓全部清除,7例患者的11处髂静脉狭窄经PTA治疗后效果满意,另24例患者的27处髂静脉狭窄PTA后效果不佳,经置入静脉内支架后狭窄解除。术后随访5～49.5个月,平均27.4个月,临床无复发。结论:血管腔内技术治疗髂静脉压迫综合征并发急性髂-股静脉血栓形成微创、安全、有效。治疗后近、中期疗效显著,但其长期疗效尚需作大样本的进一步观察。

Objective:To evaluate the clinical feasibility of the comprehensive application of endovascular techniques in treating acute ilˉiofemoral venous thrombosis caused by iliac vein compression syndrome.Methods:Transjugular iliofemoral venous thrombectomy,PTA and/or enˉdovascular stent placement were sequentially performed after inferior vena cava filter implantation.Results:All the31patients had complete clot lysis.eleven iliac vein narrowings in7of the31patients were successfully treated by deployment of PTA and27narrowings of iliac vein in the remaining patient were successfully treated by deployment of endovascular stent.All the31patients were asymptomatic with a mean follow-up of27.4months(range,5～49.5).Conclusion:The comprehensive application of transjugular iliofemoral venous thrombectomy,PTA and/or enˉdovascular stent placement for the treatment of acute iliofemoral venous thrombosis caused by iliac vein compression syndrome is a safe,effective and microinvasive method with high patency rate in the short and medium-term.