非急性期髂股静脉血栓形成介入治疗的价值

Interventional Treatment of Non-Acute Iliofemoral Venous Thrombosis

目的 探讨非急性期髂股静脉血栓形成的综合性介入治疗的临床价值。方法 在下腔静脉置入滤器后 ,应用经颈静脉髂 股静脉血栓清除术、经导管接触性溶栓术和经皮腔内血管成形术 (PTA)等多种血管介入技术进行综合性介入治疗。结果 滤器置入成功率为 10 0 % ,7例患者经上述综合性介入治疗后有 5例患者血栓完全清除 (71.4% ) ,1例血栓部分清除 (14 .3 % ) ,1例无效 (14 .3 % ) ,5例血栓完全清除患者术后随访 2～ 5 3个月 (中位随访期 2 9个月 ) ,临床无症状复发。 1例血栓部分清除患者术后症状减轻 ,随访期内症状反复。 7例患者术中、术后未发生肺动脉栓塞 ,6例随访患者随访期内未发生肺动脉栓塞。结论 经颈静脉髂 股静脉血栓清除术、经导管接触性溶栓术及PTA等介入技术的综合应用是治疗非急性期髂股静脉血栓形成的一种简便、实用、安全、有效、微创的治疗手段。

Objective To evaluate the clinical feasibility of the comprehensive application of interventional techniques in treating non acute iliofemoral venous thrombosis. Methods Transjugular iliofemoral venous thrombectomy,catheter directed thrombolytic therapy and PTA were sequentially performed after inferior vena cava filter was implanted. Results All the IVC filters were placed successfully.Five of the 7 patients with non acute iliofemoral venous thrombosis had complete clot lysis and were asymptomatic with a mean follow up of 29 months (range,2-53),one patient had partly clot lysis and his symptom recurred in the 5 month follow up. Conclusion The comprehensive application of transjugular iliofemoral venous thrombectomy,PTA and catheter directed thrombolytic therapy for the treatment of non acute iliofemoral venous thrombosis is a safe,effective and microinvasive method.