髂股静脉血栓综合征的腔内治疗

Endovenous treatment for postthrombotic syndrome

目的评价腔内支架植入术治疗髂股静脉血栓形成后遗症的治疗效果。方法回顾性分析2007-12—2013-12上海交通大学医学院附属第九人民医院血管外科收治的179例髂股静脉PTS患者(187条肢体),评价近中期支架通畅率及临床改善情况。结果技术成功率为95.2%,平均植入支架2.0枚。术中发现血管穿孔38例,均为自限性,无围手术期死亡、肺栓塞及出血等严重并发症。术后随访平均33个月,3年一期通畅率为69.6%,二期通畅率为92.0%。Villalta评分由术前(21.0±5.1)分至术后(9.7±3.5)分(P<0.001),差异具有统计学意义。结论目前腔内支架植入术可以作为治疗中重度PTS患者的首选方案。

Objective To evaluate the efficacy of endovenous stenting for postthrombotic syndrome(PTS) in iliac-femoral veins. Methods 179 patients(187 limbs) with iliac-femoral vein stenosis/occlusion were treated by stent implantation from December 2007 through December 2013 were retrospectively reviewed. Patency rate and clinical improvements were analyzed. Results Technical success rate was 95.2%. The mean number of stent implantation was 2.38 perforation were found during the procedures, they were all self-limited. No severe complications and peri-operative deaths were occurred. Mean follow-up was 33 months. Primary patency rate and secondary patency rate at 3 years were 69.6% and 92.0%. Villalta Score was 9.7 nica after operations, which was significantly increased(P<0.001). Conclusions Stent implantation in iliac-femoral veins can be a first-line treatment for moderate-severe PTS patients.