下腔静脉滤器在下肢深静脉血栓治疗中的意义

目的评价置入下腔静脉滤器预防下肢深静脉血栓脱落引起肺栓塞的价值及实行导管溶栓的方法.方法34例下肢深静脉血栓患者分别经右侧股静脉(26例)或右颈静脉(8例)置入波士顿公司的Greenfield滤器或巴德公司Simon's滤器.下腔静脉滤器置人后,将溶栓导管经右股静脉插人到左髂总静脉,经右颈内静脉插入到左髂总静脉进行溶栓.药物尿激酶100～150万u.结果下腔静脉滤器置入全部成功.溶栓经右侧股静脉26例,成功12例,成功率为47%;经颈静脉8例均成功.结论置人下腔静脉滤器防肺栓塞是操作简单、安全有效的方法.经颈静脉溶栓,成功率高,效果好,值得推广.     

经颈静脉介入治疗不同类型左髂静脉压迫综合征伴血栓形成

目的 评价经颈静脉介入治疗不同类型左髂静脉压迫综合征(IVCS)伴血栓形成的疗效.方法 120例左IVCS伴血栓形成的患者,全部经颈静脉插管行尿激酶溶栓治疗,52例患者施行腔静脉滤器置入、65例行左髂总静脉成形术.结果 120例包括左髂总静脉闭塞或重度狭窄伴髂股静脉血栓68例,左髂总静脉闭塞或狭窄伴髂股静脉及下腔静脉血栓32例及左髂总静脉轻度狭窄(＜60%)伴髂股静脉血栓或下腔静脉血栓20例.血栓完全溶解98例,部分溶解22例.55例随访2～24个月,血栓复发2例,髂静脉支架闭塞2例.结论 经颈静脉介入治疗不同类型左IVCS伴血栓形成是一种安全、有效的方法.     

机械性血栓清除术联合同期髂静脉支架植入治疗合并左髂静脉受压综合征的急性下肢深静脉血栓形成

目的：评价经皮机械性血栓清除术联合同期髂静脉支架植入治疗合并左髂静脉受压综合征的急性下肢深静脉血栓（DVT）形成的可行性、安全性及有效性。 方法：选取2015年4月-2017年6月收治左髂静脉受压综合征伴急性下肢DVT的患者33例,发病时间6 h-14 d,平均年龄（57.97±14.44）岁。所有患者均在滤器保护下进行治疗。AngioJet血栓清除术、球囊扩张和髂静脉支架植入均在同期完成,术后保留鞘管予以溶栓治疗,每天复查造影,若血栓完全溶解,取出下腔静脉滤器并结束溶栓。术后第1、3、6、12个月进行门诊随访,行彩色超声和（或）下肢静脉造影检查了解下肢深静脉及髂支架内血流通畅情况。 结果：33例患者均同期完成手术,技术成功率100%,AngioJet抽吸时间为（224.70±72.78）s,溶栓时间（34.00±15.37）h,尿激酶用量（112.58±49.92）万U。33例患者同期植入髂静脉支架33枚。血栓清除率Ⅲ级患者29例,血栓清除率Ⅱ级患者4例。无出血、症状性肺栓等严重并发症发生。术后随访1例患者术后两月血栓复发,32例患者术后随访超声和（或）下肢静脉造影检查提示下肢深静脉及髂静脉支架内血流通畅。 结论：机械性血栓清除术联合同期髂静脉支架植入治疗合并左髂静脉受压综合征的急性下肢深静脉血栓形成是一种安全有效的方法。     

溶栓导管治疗下肢深静脉血栓形成的临床应用

目的评价溶栓导管治疗下肢深静脉血栓形成(DVT)的疗效。方法2003年4月～2004年10月,32例左下肢DVT患者施行了溶栓导管置入术,采用抗凝及经溶栓导管脉冲式灌注尿激酶治疗。其中行下腔静脉滤器置入术11例、行髂总静脉球囊扩张术10例,行髂总静脉支架置入术2例。结果溶栓导管平均放置时间为(7.7±2.3)d。下肢水肿完全消退28例,部分消退4例。左下肢深静脉血栓完全溶解29例,其中12例存在左髂静脉受压综合征;血栓部分溶解3例。无出血、肺动脉栓塞等并发症。结论采用溶栓导管治疗下肢DVT是一种安全、有效的方法。     

Cockett综合征伴下肢深静脉血栓的治疗

目的 探讨介入治疗对Cockett综合征伴下肢深静脉血栓形成的临床价值.资料与方法 对2003年12月至2007年7月收治的37例Cockett综合征伴下肢深静脉血栓患者分别采用股静脉、腘静脉或胫后静脉置管溶栓和经皮血管内球囊扩张/支架置入术等血管介入技术进行综合性治疗,观察治疗效果.结果 37例中治愈22例,显效11例,有效4例,总有效率100%,除3例因左髂静脉完全闭塞,置入导丝未能成功外,单纯球囊扩张11例,支架置入23例.本组患者术中、术后无并发症,溶栓过程中未出现出血.临床随访6～12个月,平均9个月,临床无复发,未发现支架移位和变形.结论 综合介入治疗是治疗Cockett综合征伴下肢深静脉血栓的一种安全、有效、微创的治疗手段,值得临床推广.     

滤器置入联合手术取栓治疗产后下肢DVT的临床分析

目的 总结产后急性期单侧下肢深静脉血栓形成(DVT)腔静脉滤器联合手术取栓治疗的疗效及应用.方法 回顾性分析59例产后单侧下肢急性期DVT行腔静脉滤器联合手术取栓治疗的患者临床资料.结果 56例成功行腔静脉滤器置入及手术切开取栓,3例因髂静脉近端血栓闭塞严重无法开通,股静脉切口远端成功行手术取栓,术后拔除腔静脉滤器.本组有效率为100%,治愈率为88.1%,无死亡及新发肺动脉栓塞病例.随访3~36个月,1例髂静脉狭窄病例于球囊扩张3个月后复发,再次手术置入髂静脉支架后患肢肿胀明显减轻.结论 腔静脉滤器置入联合手术取栓治疗急性期产后单侧下肢DVT安全可行、疗效确切.     

下肢深静脉血栓综合性介入治疗

目的 回顾性分析下肢深静脉血栓(DVT)综合性介入治疗的方法及疗效,并就相关临床资料和并发症进行总结.方法 收集2000年8月-2010年8月DVT患者196例,先经健侧股静脉穿刺置管行髂股静脉造影明确血栓部位与程度.196例中,放置下腔静脉滤器185例,髂静脉支架21例,采用经导管溶栓、扩张球囊破栓.若球囊对狭窄部扩...     

介入治疗急性左髂股静脉血栓——先溶栓或先扩张

目的 评价两种不同介入治疗程序(先溶栓或先扩张)在治疗急性左髂股静脉血栓中的近期疗效和并发症发生率的差异.方法 将45例急性左下肢中央型深静脉血栓患者分为两组.A组21例,经左侧胭静脉插入溶栓导管到髂股静脉血栓内,行导管溶栓,治疗后如有残留狭窄,再行球囊扩张或支架置人.B组24例,经左侧胭静脉置鞘,对左侧髂静脉和血栓先...     

恶性肿瘤引起髂股静脉重度狭窄继发下肢深静脉血栓形成的介入治疗

目的 探讨恶性肿瘤引起的髂股静脉受压重度狭窄继发下肢深静脉血栓形成的介入治疗的安全性及有效性.方法 回顾性分析因恶性肿瘤引起髂股静脉重度狭窄继发下肢深静脉血栓形成的患者临床资料.采用球囊辅助碎栓、血栓抽吸、经导管溶栓、支架植入等介入治疗.统计并分析患肢消肿率,患肢血栓清除率;术后第1、3、6、12个月进行门诊随访,行下...     

髂静脉受压综合征与单侧下肢肿胀

目的探讨髂静脉受压综合征在单侧下肢肿胀病因诊断中的意义及其介入治疗价值。方法左下肢肿胀者32例,经下肢静脉造影确诊为髂静脉受压,所有32例均以左股静脉为穿刺入路,以10或12mm直径的球囊对髂静脉受压或闭塞段行预扩张,然后置入直径为10～16mm的自膨式支架。所有病例术后口服抗凝药治疗6个月。结果所有病例左下肢肿胀均于术后2d内逐渐消失,无严重并发症发生。27例随访资料显示支架通畅率为100%,无深静脉栓塞发生。结论早期发现和治疗髂静脉受压能防止发生下肢深静脉血栓。     

Distinction of hepatic vein from portal vein by MR imaging

Fast magnetic resonance (MR) imaging techniques are assuming importance in imaging of the abdomen in part due to their ability to produce images during breath-holding, which ensures high spatial resolution and no respiratory motion artifacts. One problem with rapid scanning of the liver, shared with other MR techniques, is confusion between portal and hepatic veins due to similarity in signal intensity. The fast low angle shot (FLASH) technique (flip angle 40 degrees, repetition time 28 ms, and echo time 16 ms) produces high signal in both venous systems. To remedy the problem we incorporated presaturation pulses applied across the portal and mesenteric veins to the FLASH technique; this induced a decrease in signal in the portal venous system and facilitated their differentiation from hepatic veins. Moreover, in one patient an intraportal tumor thrombus not detected on the standard FLASH technique was rendered visible by presaturation. Although the presaturation pulses in the present series were confined to the sagittal plane, the technique should be applicable in any plane as dictated by the anatomy and direction of blood flow. We anticipate wide use of combined presaturation and rapid scanning techniques.     

Anomalous intrapulmonal vein drainage and pulmonary vein connection in DSA

Anomalous pulmonary venous drainage can be detected and evaluated by angiographic studies. Now that intravenous DSA is available, this method can be used to demonstrate pulmonary venous return. This study presents the results of DSA examination in three patients having anomalous pulmonary vein connection with the left innominate vein and the superior vena cava respectively. In a fourth patient, intra-pulmonary atypical venous return could be demonstrated by DSA without anomalous connection. This minimal invasive procedure is diagnostically useful in anomalies of pulmonary veins when recommended post-processing techniques are evaluated, particularly in patients with additional cardiac septal defects.     

Retroaortic left renal vein with renal vein hypertension causing hematuria

We describe a case of retroaortic left renal vein with hematuria. In this case, pullback pressure from the retroaortic left renal vein to the inferior vena cava revealed left renal vein hypertension according to criteria of the “nutcracker phenomenon.” We stress that left renal vein anomaly including retroaortic left renal vein can cause clinical symptoms such as hematuria.     

Retroaortic left renal vein joining the left common iliac vein

Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 °C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly. Received: 18 October 1999; Revised: 11 February 2000; Accepted: 15 February 2000     

Ovarian vein thrombosis

Ovarian vein thrombosis is a well-known but rare entity, which can occur during the post-partum period. This condition has also been associated with inflammatory and malignant processes within the pelvis. Untreated, complications of ovarian vein thrombosis can be significant due to the associated sepsis and risk of pulmonary embolism. Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the post-partum patients, with anticoagulation therapy being the current recommendation.