下肢深静脉血栓形成后综合征的血管腔内治疗

Endovascular treatment for deep vein post-thrombotic syndrome of lower extremity

目的探讨下肢深静脉血栓形成后综合征(post-thrombotic syndrome,PTS)的微创治疗效果。方法回顾性分析2008年1月至2014年12月中国人民解放军第一〇七医院血管外科收治的262例中275条肢体PTS患者的临床资料。本组患者均行局部麻醉下的血管腔内微创介入治疗。其经皮血管腔内成形术74条肢体;血管成形联合支架置入201条肢体,并对其疗效进行总结。结果手术成功268条肢体(97.5%),闭塞血管完全开通,恢复正常的血液回流;7条肢体左髂总静脉段未能完全开通。随访240例(91.6%),随访时间12~96个月,平均(48.3±20.2)个月。其中完全缓解94条肢体(34.2%);明显缓解174条肢体(63.3%);轻度缓解7条肢体(2.5%)。结论下肢深静脉血栓形成后综合征的微创介入治疗创伤小、恢复快、疗效可靠。

Objective To evaluate the effect of endovascular treatment for deep vein post-thrombotic syndrome of lower extremity.Methods From January2008to December2014,the clinical data of262patients(275limbs)with PTS were analysed retrospectively.All patients in this group were treated by endovascular treatment under local anesthesia.Among them,74limbs underwent percutaneous transluminal angioplasty(PTA),201limbs received PTA and stent-grafts implanted.Results Based on angiography during operation,the obstructed iliofemoral vein received complete recanalization in268limbs(97.5%)and partial recanalization in7limbs with the entrance of common iliac vein to inferior vena cava obstructed.Of the262cases,240cases were followed-up with mean time of(48.3±20.2)months,ranging from12to96months and94limbs received complete remission with normal life,signifi cent remission in174limbs,partial remission in7limbs.Conclusions Endovascular management is a minimally-invasive,safe and effective treatment for PTS.