经腘静脉介入治疗左侧髂静脉压迫综合征伴血栓形成的临床应用

Clinical Application of Interventional Therapy for the Left Iliac Vein Compression Syndrome Complicated by Thrombosis via Popliteal Vein

目的探讨经腘静脉入路介入治疗左侧髂静脉压迫综合征(ICS)伴血栓形成的临床价值。方法对2010年2月至2013年3月间荆州市第一人民医院收治的12例左侧ICS伴血栓形成患者行下腔静脉滤器置入、导管溶栓及球囊扩张+支架成形术治疗。结果所有病例ICS经左侧腘静脉穿刺、插管造影可见左侧髂静脉不同程度狭窄或闭塞,部分有侧支循环形成。导丝通过狭窄或闭塞段并成功进行介入治疗。术后造影示左侧髂静脉恢复通畅,侧支循环减少或消失。患者左下肢肿胀消失,未发生严重并发症。结论经腘静脉入路介入治疗左侧ICS伴血栓形成,操作方便且安全有效,可作为首选方法 。

Objective To investigate the clinical value of the interventional treatment for the left iliac vein compression syndrome complicated by thrombosis via popliteal vein. Methods A total of 12 cases of patients with left iliac vein compression syndrome complicated by thrombosis admitted in Jingzhou First People＇s Hospital from Feb. 2010 to Mar. 2013 March between were treated with inferior vena cava filter implantation, catheter directed thrombolysis,balloon dilatation and stenting treatment. Results All cases were punctured via left popliteal vein. Results of angiography showed that stenosis or occlusion was visible on the left iliac vein of all the cases, and some of them had collateral circulation formed. For all the cases, the guide wires successfully got through the stenosis or occlusion segment, and results of postoperative angiography showed patency of the left iliac vein, and reduction or disappearance of collateral circulation. Patients with left lower limb swelling disappeared, no serious complications occurred. Conclusion Interventional treatment via popliteal vein for the/eft iliac vein compression syndrome complicated by thrombosis is convenient to operate, safe and effective, which can be the preferred method.