综合介入治疗左下肢深静脉血栓合并Cockett综合征临床分析

目的探讨急性左下肢深静脉血栓形成合并Cockett综合征的综合腔内介入治疗方法的应用价值。方法 2010年7月～2011年6月对57例左下肢急性深静脉血栓形成合并Cockett综合征患者采用下腔静脉滤器置入术、左下肢深静脉置管溶栓术及左髂静脉闭塞或狭窄段球囊扩张内支架术治疗,观察患者手术前后左下肢症状及体征,通过造影观察左下肢深静脉通畅情况。结果 57例患者均经下肢深静脉造影检查明确诊断,本组技术成功56例,患者下肢肿胀、疼痛等消失,盆腔侧枝循环消失。1例患者仅行抗凝治疗,下肢肿胀好转。治疗过程中患者未发生滤器、支架移位等情况,未发生血栓复发、肺动脉栓塞、出血并发症等。术后口服抗血小板药物至少3～6个月,随访2～12个月,11例患者左下肢肿胀,7例患者出现下肢静脉曲张,所有患者未发生下肢溃疡,6、12个月后复查造影无支架内阻塞病例。结论综合介入治疗左下肢深静脉血栓形成合并Cockett综合征微创、安全,术后口服抗凝药物可提高下肢深静脉通畅率,临床疗效确切。

Comprehensive international therapy in treating deep vein thrombosis(DVT)of left lower extremity complicated with Cockett syndrome

Objective To evaluate comprehensive international therapy in treating deep vein thrombosis(DVT) of left lower extremity complicated with Cockett syndrome.Methods From Jul 2010 to Jun 2011,inferior vena cava filter implantation,thranscatheter thrombolysis of deep vein,balloon dilatation angioplasty and stent implantation were performed in 57 patients with deep vein thrombosis(DVT) of left lower extremity complicated with Cockett syndrome.The relief of symptoms and signs between before and after operation were observed.The unobstruct of deep vein was observed with ascending venography.Results 57 patients were all diagnosed with ascending venography,endovascular treatment were successfully performed in 56 cases,the symptoms of leg swelling and paining disappeared,pelvic collateral disappeared.Anticoagulant therapy was performed only in 1 case,the leg swelling relieved.There was no displacement of filter,sent.There were no recurrent thromboembolism,bleeding or pulmonary embolism(PE) complications during the treatment.57 cases were followed 2～12 months,antiplatelet therapy for 3～6 months,left leg swelled in 11 cases,varicose veins happened in 7 cases.There were no leg ulcers.There were no occlusion in sents after 6 and 12 months.Conclusion Comprehensive international therapy in treating deep vein thrombosis(DVT) of left lower extremity complicated with Cockett syndrome with anticoagulant therapy is minimally invasive,safe and effective.It can improve the unobstructed rate of the legs.