下肢深静脉血栓延伸至下腔静脉的DSA影像分析及介入治疗

The research of DSA imaging and interventional therapy about deep vein thrombosis entending to the inferior vena cava

目的：研究下肢深静脉血栓（DVP）延伸至下腔静脉的DSA表现及介入治疗疗效。方法分析13例DVP延伸至下腔静脉患者的临床资料，男性5例，女性8例，年龄35～77岁，平均49．3岁，左侧DV T 11例，右侧2例，中央型DVT 2例，混合型11例，所有患者均接受下腔静脉造影及下腔静脉滤器置入等介入治疗，对延伸至下腔静脉的血栓形态及疗效进行分析，并对双侧DVP延伸至下腔静脉的例数进行比较。结果13例患者行下腔静脉造影时发现自患肢髂静脉开口部延伸至下腔静脉的充盈缺损影像，4例表现为钝圆形充盈缺损影像（均为左侧），9例表现为长条形充盈缺损影像，其中7例为宽基底型，2例为窄基底型，所有延伸至下腔静脉内的血栓无游离；双侧DV P延伸至下腔静脉的例数间差别无统计学意义；13例患者经介入治疗后造影显示下腔静脉血栓完全消失，治疗过程中无PE发生，经随访无复发。结论DVP延伸至下腔静脉更易导致PE ，血管造影可以明确诊断，介入治疗的疗效无疑是显著的。

Objective To research the DSA imaging and interventional therapy about deep vein thrombosis extending to the inferior vena cava .Methods 13 patients with deep vein thrombosis （DVT ） extending to the inferior vena cava were reviewed .There were 5 males and 8 females ,aged 35~77 ,mean 49 .7 .Left DVT was 11 and right 2 .Central type was 2 and mixed type 11 .And all patients received interventional therapy .We analysed the form of thrombus in the inferior vena cava and curative effect ,and compared the incidence rate of bilateral DVP extending to the inferior vena cava .Results The filling defect coming from the iliac vein extending to the inferior vena cava was found in all 13 ,4 exbibited blunt round and the other 9 exbibited strip ,among 9 strips ,7 exbibited broad base type and the other 2 narrow base type .There was no free of thrombus ,and the comparison of the incidence rate of bilateral DVP extending to the inferior vena cava was not statistical significance .All 13 patients were treated by interventional therapy after angiography showing inferior vena cava thrombosis disappeared ,no PE occurred during the treatment and no recurrence by follow‐up visit .Conclusion There is more incidence rate in the DVP extending to the inferior vena cava ,angiography can confirm the diagnosis ,and interven‐tional therapy is significant undoubtedly .