不同类型Cockett综合征腔内治疗临床疗效分析

Analysis for the therapeutic efficacy of endovascular treatment in different types of the Cockett syndrome

目的：对不同类型Cockett综合征的腔内治疗的疗效分析。方法2011年8月～2014年2月，对25例Cockett综合征患者根据不同阶段、不同类型及其病变程度给予腔内血管重建。25例患者中，6例患者（髂静脉狭窄大于30％，小于80％侧支循环欠佳，无下肢深静脉血栓形成）给予单纯球扩成形术，17例患者（髂静脉狭窄大于30％合并急性期左下肢深静脉血栓形成）给予置管溶栓后给予髂静脉成形术，2例患者（小于80％侧支循环欠佳下肢静脉性淤血较重或髂静脉狭窄大于80％，合并皮炎及溃疡等）给予球扩成型后支架植入术。结果手术成功率为100％，共植入3枚自膨式血管支架。随访时间为3～39个月，平均16.3个月。采用生活质量调查问卷形式对患者进行评价，23例患者符合治愈标准；1例患者符合治疗好转标准，1例因未规律口服抗凝药物复发。结论不同阶段Cockett综合征的腔内积极治疗是必要的，对其导致的下肢慢性静脉功能不全、下肢深静脉血栓形成及血栓后遗症等的预防及治疗有积极意义。

Objective To evaluate the therapeutic efficacy of endovascular treatment in different types of the Cockett syndrome. Methods 25 patients with Cockett syndrome were treated with endovascular reconstruction from August 2011 to February 2014 according to the different stages, types and severity degree of the desease. Among them, six （whose iliac vein stenosis is over 30%, poor collateral circulation is less than 80% with no deep venous thrombosis in lower limbs） were given endovascular revascularization therapy. Seventeen （whose iliac vein stenosis is over 30%with deep venous thrombosis in the left lower limb in merge acute stage） were treated with endovascular revascularization after catheter-directed thrombolysis. Two （whose poor collateral circulation and heavy venous congestion in lower limbs is less than 80%, iliac vein stenosis is over 80% with merge dermatitis and ulceration） were given self-expandable stents after endovascular revas-cularization. Results The successful rate of this therapy was 100%, and 3 self-expandable stents were implanted in total. All cases were followed-up for 3 to 39 months （mean, 16.3 months）. Questionares about living quality were given to those previous patients and the findings： 23 of them meet the cure standards;1 patient was getting better;1 patient relapsed because of not taking anticoagulant regularly. Conclusion The endovascular treatment of Cockett syndrome in different stages is indispensable, for it has great positive significance to the prevention and treatment of restenosis, DVT and PTS.