上腔静脉综合征的介入治疗

Treatment of Superior Vena Cava Syndrome by Means of Thrombolysis and Endovascular Stent Placement

目的 探讨血管腔内成形技术在上腔静脉综合征 (SVCS)治疗中的应用价值。方法 14例SVCS患者 ,男 11例 ,女 3例。病因包括 :中心型肺癌 9例 ,纵隔转移瘤 4例 ,淋巴瘤 1例。应用经导管局部溶栓 +内支架成形术 (PTAS)治疗。结果 初次治疗的血管再通率为 86% ,术后 2 4～ 48h内患者的临床症状即有明显减轻 ,随访 1～ 2 0个月 (平均 8.3个月 ) ,仅 4例于术后 2周内发生支架再狭窄 ,经再次治疗效果满意。结论 血管腔内成形术是治疗上腔静脉综合征的有效方法。

Objective To evaluate the value of endovascular therapy in the treatment of superior vena cava syndrome (SVCS). Methods Fourteen consecutive patients (11 men, 3 women ) with superior vena cava syndrome underwent local thrombolysis and endovascular stent placement. The cause was central bronchogenic carcinoma in 9, metastatic tumor in 4, and lymphoma in 1. Results The primary recanalization rate was 86%. The symptoms disappeared or alleviated obviously in 12 patients within 24～48 hours after the treatment. During the follow up of 1 to 20 months (average 8.3 months ), there were only 4 restenosis that could be treated successfully. Conclusion Catheter directed thrombolysis and endovascular stent placement is a safe and effective treatment for superior vena cava syndrome.