下肢深静脉血栓形成后综合征的介入治疗

Interventional Treatment of Post-thrombosis Syndrome

目的探讨介入治疗下肢深静脉血栓形成后综合征的临床效果。方法 2011年3月~2016年1月我院对91例下肢深静脉血栓形成后综合征行介入治疗,俯卧位,以腘静脉为穿刺入路途径,建立工作导丝通道,然后行血管成形术或支架植入治疗。结果手术技术成功率98.9%(90/91),狭窄或闭塞血管开通成功,血流恢复通畅;1例左髂静脉未开通成功,但侧支循环丰富足以代偿。90例治疗成功者随访6~30个月,(18.5±2.3)月,术后3、12、24个月血管通畅率分别为93.3%(84/90)、81.3%(61/75)、71.4%(20/28),无一例出现支架移位、溃疡复发。结论血管腔内介入治疗下肢深静脉血栓形成后综合征,技术成功率高,临床疗效确切,是安全、有效的方法。

Objective To investigate the clinical effect and value of interventional therapy for post-thrombosis syndrome （PTS）.Methods Clinical data of 91 patients with PTS who had received interventional therapy were retrospectively analyzed.The patients were in prone position in surgery.We selected puncture approach of popliteal vein and established a working guidewire channel, and then performed balloon dilatation and stent placement.Results The technical success rate was 98.9% （90/91）, with complete recanalization of the stenosis or occluded vessel and restoration of the normal blood flow.There was 1 case of failure to traverse the left common iliac vein segment, but the collateral circulation was rich enough to compensate.The 90 patients were followed up for 6-30 months, with a mean of （18.5±2.3） months.The 6, 12, and 24-month patency rates were 93.3% （84/90）, 81.3% （61/75）, and 71.4%（20/28）, respectively.No stent migration or ulcer recurrence occurred in the 90 patients during the follow-ups.Conclusion For the treatment of PTS, endovascular treatment has high technical success rate.With satisfactory clinical effect, this therapy is safe and effective.