左髂静脉压迫综合征并急性左下肢深静脉血栓的治疗探讨

Clinical management of patients with Cockett syndrome complicated with acute left deep vein thrombosis

目的 探讨腔内治疗左髂静脉压迫综合征（Cockett综合征）并急性左下肢深静脉血栓的临床疗效及安全性.方法 对21例Cockett综合征并发左下肢深静脉血栓形成患者采用经腘静脉置管溶栓、左髂静脉球囊扩张及支架置入治疗,所有患者在术前均行可回收性下腔静脉滤器置入.结果 术后患肢肿胀症状均消失或明显减轻,造影疗效评价：Ⅰ级10例,Ⅱ级8例,Ⅲ级3例.结论 采用滤器置入、经腘静脉溶栓、球囊扩张及支架置入治疗Cockett综合征并发左下肢深静脉血栓形成是一种安全、微创、有效的治疗手段,具有较好的效果,值得临床推广.

Objective To evaluate the efficacy and safety of endovascular treatment for Cockett syndrome complicated with acute left deep vein thrombosis. Methods Transcatheter thrombolysis via popliteal vein catheterization, balloon dilatation angioplasty and stent implantation were performed in 21 patients with Cockett syndrome complicated with acute left deep vein thrombosis. Inferior vena cava filter implantation was carried out before thrombolyfic therapy. Results In all eases, postoperative swelling of affected limbs lessened or disappeared. Treatment result was assessed by radiography as grade I in 10 pa- tients,grade H in 8, and grade IU in 3. Conclusion For Cockett syndrome complicated with acute left deep vein thrombosis, the combination of inferior vena cava filter implantation, catheter-directed thrombolysis via popliteal vein, and balloon dilatation together with stent placement is a safe, mini-invasive and effective therapy.