髂静脉压迫综合征致急性髂-股静脉血栓形成的介入治疗

目的　探讨髂静脉压迫综合征所致急性髂 股静脉血栓形成的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、PTA和 /或经皮血管内支架置入术等血管介入技术进行综合性介入治疗。结果　 6例患者经上述综合性介入治疗后血栓全部清除 ,5例患者的 7处髂静脉狭窄经PTA治疗后效果满意 ,另 1例患者的2处髂静脉狭窄PTA后效果不佳 ,经置入 1枚Wallstent(14mm× 80mm )和 1枚国产Z型 (16mm× 5 6mm )静脉内支架后狭窄解除。术后随访 5～ 3 3 .5个月 ,平均 19.4个月 ,临床无复发。结论　经颈静脉髂 股静脉血栓清除术、PTA及经皮血管内支架置入术等介入技术的综合应用是治疗髂静脉压迫综合征所致急性髂 股静脉血栓形成的一种安全、有效、微创的治疗手段。治疗后近、中期疗效显著 ,但其长期疗效尚需做大样本的进一步观察

Interventional Management of Acute Iliofemoral Venous Thrombosis Caused by Iliac Vein Compression Syndrome

Purpose To evaluate the clinical feasibility of the comprehensive application of interventional techniques in treating acute iliofemoral venous thrombosis caused by iliac vein compression syndrome. Methods Transjugular iliofemoral venous thrombectomy, PTA and/or endovascular stent placement were sequentially performed after inferior vena cava filter was implanted. Results All the 6 patients had complete clot lysis. Seven iliac vein narrowings in 5 of the 6 patients were successfully treated by deployment of PTA and 2 narrowings of iliac vein in the remaining patient were successfully treated by deployment of a Wallstent endoprosthesis and a Z stent. All the 6 patients were asymptomatic with a mean follow up of 19.4 months(range, 5-33.5 months). Conclusion The comprehensive application of transjugular iliofemoral venous thrombectomy, PTA and/or endovascular stent placement for the treatment of acute iliofemoral venous thrombosis caused by iliac vein compression syndrome is an safe, effective and microinvasive method with high patency rates in the medium term.