568例髂静脉受压介入治疗体会

目的 总结髂静脉受压综合征（IVCS）血管腔内介入治疗的经验.方法 对568例髂静脉受压患者采用血管腔内介入治疗,其中单纯经皮血管腔内成形（percutaneous transluminal angioplasty,PTA）352例,腔内成形加支架置入（PTA＋ stent）216例.合并下肢深静脉血栓形成的IVCS患者,采用手术取栓、置管溶栓加PTA,必要时支架置入治疗.对采用单纯PTA及PTA＋ stent 的出院后3个月及12个月的有效率及优良率进行回顾性对比分析.结果 553例患者手术成功,成功率97.4％（553/568）.患者出院后3个月及12个月的有效率单纯PTA的为94.0％、86.9％,PTA＋ stent的为95.9％、96.1％;优良率单纯PTA的为81.3％、70.4％,PTA＋ stent的为91.3％、91.7％.两组比较,出院后3个月的有效率差异无统计学意义（x2=0.90,P＞0.05）;优良率差异有统计学意义（x2 =9.56,P＜0.05）.出院后12个月的有效率及优良率差异均有统计学意义（x2=10.95,P＜0.05;x2=296.35,P＜0.05）.结论 PTA＋ stent较单纯PTA在治疗IVCS的近期、中期疗效更佳.

Interventional treatment for iliac vein compression syndrome：experience of 568 cases

Objective To summarize the experience of endovascular interventional therapy for iliac vein compression syndrome（IVCS）.Methods A total of 568 patients with IVCS were treated with endovascular interventional therapies,including 352 cases of simple percutaneous transluminal angioplasty （PTA） and 216 cases of PTA plus stent implantation （PTA ＋ stent）.Additional embolectomy or catheterdirected thrombolysis （CDT）was performed in IVCS patient with deep venous thrombosis（DVT）.The efficiency and excellent-good rates at the 3rd and 12th months after interventional therapies were analyzed retrospectively.Results Operations were successfully performed in 553 cases and the success rate was 97.4％ （553/568）.The efficiencies at the 3rd and 12th months were 94.0％ and 86.9％ in the PTA group,and 95.9％ and 96.1％ in the PTA ＋ stent group.The excellent-good rates at the 3rd and 12th months were 81.3％ and 70.4％ in the PTA group,and 91.3％ and 91.7％ in the PTA ＋ stent group.There was no statistical difference in efficiency at the 3rd months between groups（x2 =0.90,P ＞ 0.05）,but a significant difference in excellent-good rate was observed （x2 =9.56,P ＜ 0.05）.Statistical differences in efficiency and excellent-good rate at the 12th months were both significant（x2 =10.95,P ＜ 0.05 ; x2 =296.35,P ＜ 0.05）.Conclusion In the treatment of IVCS,PTA plus stent implantation is superior to simple PTA in short and middle term efficiency.