下肢深静脉血栓形成后综合征的腔内治疗

Endovascular treatment for post-thrombotic syndrome following lower extremity deep venous thrombosis

目的：探讨下肢深静脉血栓形成后综合征（PTS）的血管腔内微创治疗效果。方法：回顾性分析7年间收治的262例（275条肢体）下肢深静脉PTS患者的临床资料。患者均行局部麻醉下的血管腔内微创介入治疗。其中经皮血管腔内成形74条肢体,血管成形联合支架置入201条肢体。结果：手术成功268条肢体（97.5%）,闭塞血管完全开通,恢复正常的血液回流;7条肢体未能完全开通（左髂总静脉段未能开通）经腰升静脉回流或侧支代偿。240例（91.6%）253条肢体获随访8~96个月,平均（48.3±20.2）个月,其中完全缓解94条肢体（37.2%）;明显缓解152条肢体（60.0%）;轻度缓解7条肢体（2.8%）。结论：下肢深静脉PTS的微创介入治疗创伤小、恢复快、疗效可靠。

Objective： To evaluate the outcomes of minimally invasive endovascular treatment for post-thrombotic syndrome （PTS） following deep vein thrombosis （DVT） of the lower extremity. Methods： The clinical data of 262 PTS patients （275 limbs） after lower extremity DVT treated within 7 years were retrospectively analyzed. All patients underwent minimally invasive endovascular treatment under local anesthesia. In these patients, 74 limbs underwent percutaneous transluminal angioplasty （PTA）, and 201 limbs received PTA plus stent placement. Results： Two-hundred and sixty-eight legs （97.5%） were successfully treated, with complete recanalization of the occluded vessel and restoration of the normal blood flow. Seven legs （failure to traverse the left common iliac vein segment） were partially recanalized via ascending lumbar vein or collateral veins. Two-hundred and forty patients （91.6%）, 253 legs were followed up for 8 to 96 months with mean period of （48.3±20.2） months, and 94 limbs （37.2%） achieved complete relief, 152 limbs （60.0%） obtained significant relief, and 7 limbs （2.8%） had minor relief. Conclusion： Endovascular management is an effective treatment for PTS following lower extremity DVT with minimal invasiveness and fast recivery.