髂静脉支架植入治疗髂静脉完全闭塞的疗效分析

Analysis of the curative effect of iliac vein stent placement in the treatment of total occlusions of the iliac veins

目的评估髂静脉支架植入治疗下肢静脉血栓形成后综合征(post-thrombotic syndrome,PTS)髂静脉完全闭塞患者的安全性和有效性。方法回顾性分析2017年1月至2019年10月佛山市第一人民医院21例采用髂静脉支架植入治疗PTS髂静脉完全闭塞患者的临床资料。患者术后1、6和12个月门诊随访评估手术并发症情况、生活质量评分、Villalta评分,评估髂静脉支架术后12个月的一期通畅率。结果18例患者成功完成支架手术,技术成功率85.7%。无围术期死亡或肺栓塞发生。18例成功开通患者中17例获得随访,随访时间12个月,髂静脉支架术后12个月的一期通畅率为88.2%。患者术后1、6、12个月的Villalta评分、生活质量评分和术前相比均明显降低(P<0.05)。结论髂静脉支架植入治疗PTS髂静脉完全闭塞是一种有效,安全且可行的方法,但要选择合适的、预计能从中受益的患者。

Objective To evaluate the efficacy and safety of iliac vein stent placement in the treatment of total occlusions of iliac veins in post-thrombotic syndrome(PTS).Methods The clinical data of 21 patients who were underwent iliofemoral vein stent implantation in the treatment of total occlusions of the iliac veins in PTS iliac from January 2017 to October 2019 in the First People’s Hospital of Foshan were analyzed retrospectively.Patients were followed up at 1,6 and 12 months postoperatively to assess surgical complications,quality of life scores and Villalta scores,and to assess the primary patency rate of the iliac vein stent after 12 months.Results 18 patients successfully completed the stent implantation,and the technical success rate was 85.7%.No perioperative death or pulmonary embolism occurred.Seventeen of 18 technical success cases were followed up for 12 months.The primary patency rate of the iliac vein stent at12 months after surgery was 88.2%.The Villalta score and quality of life score in patients at 1,6,and 12 months after surgery were significantly lower than those before surgery(P<0.05).Conclusion Iliac vein stent implantation is an effective,safe and feasible method for the treatment of total occlusions of iliac veins in PTS.It is necessary to select suitable patients who are expected to benefit from the implantation.