经皮腔内微创治疗非急性期髂股静脉血栓形成

The comprehensive interventional treatment of non-acute iliofemoral venous thrombosis

目的:探讨经皮血管腔内途径微创治疗非急性期髂股静脉血栓形成的疗效及其临床价值.方法:在下腔静脉置入滤器后,采用经皮血管腔内途径联合应用经颈静脉髂-股静脉血栓清除术、导管接触性溶栓术、经皮腔内血管成形术(PTA)等多种血管腔内微创治疗技术进行综合性治疗.结果:滤器置入成功率为100%,17例患者经上述综合性介入治疗后有15例患者血栓完全清除(88.2%),1例血栓部分清除(5.9%),1例无效(5.9%),15例血栓完全清除患者术后随访3～73个月(中位随访期24个月),临床无症状复发.1例血栓部分清除患者术后症状减轻,随访期内症状反复.17例患者术中、术后未发生肺动脉栓塞,16例随访患者随访期内未发生肺动脉栓塞.结论:经颈静脉髂-股静脉血栓清除术、经导管接触性溶栓术及PTA等多种血管腔内微创治疗技术的联合应用治疗非急性期髂股静脉血栓形成操作简便、安全有效.

Objective:To evaluate the clinical feasibility of the comprehensive application of percutaneous techniques in treating non-acute iliofemoral venous thrombosis.Methods:Transjugular iliofemoral venous thrombectomy,catheter-directed thrombolytic therapy and PTA were sequentially performed after inferior vena cava filter implantation.Results:All the IVC filters were placed successfully.Fifteen of17patients with non-acute iliofemoral venous thrombosis had complete clot lysis and were asymptomatic with a mean follow-up of24months(range,3～73),1patient had partly clot lysis and his symptom recured in the35-month-follow-up.Conclusion:The comprehensive application of transjugular iliofemoral venous thrombectomy,PTA and catheter-directed thrombolytic therapy for the treatment of non-acute iliofemoral venous thrombosis is a safe,effective and microinvasive method.