髂静脉受压综合征腔内治疗的临床疗效

Clinical efficacy of endovascular therapy for iliac vein compression syndrome

目的 探讨腔内治疗髂静脉受压综合征(IVCS)的临床疗效。方法 收集2021年1月至2022年2月于首都医科大学附属北京朝阳医院及中日友好医院就诊的23例IVCS患者的临床资料,IVCS合并下肢深静脉血栓(DVT)患者18例,一期行接触性导管溶栓与髂静脉支架植入;单纯静脉曲张患者4例,静脉曲张合并溃疡1例,一期行大隐静脉高位结扎剥脱术及髂静脉支架植入。结果 23例患者手术成功率为100%,共植入支架25枚。随访1~12个月,髂静脉支架通畅率为100%。术前静脉临床严重程度评分(VCSS)为(6.13±1.19)分,明显高于术后的(1.00±0.35)分,差异有统计学意义(P﹤0.01)。结论 腔内治疗已经成为IVCS合并下肢静脉功能不全或DVT患者的首选方案,疗效及安全性较高,合理植入支架,规律随访能够明显提高髂静脉支架的通畅率,改善患者的生活质量。

Objective To evaluate the clinical efficacy of endovascular therapy for iliac vein compression syndrome(IVCS).Method The clinical data of 23 IVCS patients underwent endovascular therapy in Beijing Chao-Yang Hospital,Capital Medical University and Beijing Sino-Japan Friendship Hospital from January 2021 to February 2022 were collected,including 18 deep vein thrombosis(DVT)with catheter-directed thrombolysis and stent implantation,4 simple great saphenous varicose and 1 varicose ulcer with high ligation and stripping of great saphenous vein and stent implantation.Result The surgical success rate was 100%in 23 patients,a total of 25 stents were implanted.All patients were followed up for 1 to 12 months,the primary patency was 100%.The preoperative venous clinical severity score(VCSS)was(6.13±1.19)score,significantly higher than the postoperative score of(1.00±0.35),the difference was statistically significant(P<0.01).Conclusion Endovascular therapy has become the preferred option for IVCS complicated with lower extremity dysfunction or DVT,it has good efficacy and safety.Appropriate stenting and regular follow up can improve the patency of iliac vein stent and quality of life.