髂-股静脉血栓性闭塞的综合性介入治疗(附10例报告)

目的:探讨综合应用下腔静脉滤器置入术,血管内溶栓术,血栓清除术,血管成形术及内支架置入术治疗髂-股静脉血栓性闭塞的疗效.方法:10例髂-股静脉血栓性闭塞患者均先行下腔静脉滤器置入术,9例为永久性滤器,1例为暂时性滤器;滤器置入后依次行血管内溶栓术,血栓清除术,血管成形术和内支架置入术,直至取得满足疗效.结果:静脉滤器置入成功率100%,并用血管内溶栓术,血栓清除术及内支架置入术9例闭塞血管再通,临床疗效满意.1例因导丝不能穿过阻塞静脉未进行继续治疗.总有效率达90%,无严重无发症发生,随访3-32(平均13.5)个月,9例入永久滤器者均无肺梗发生.结论:下腔静脉滤器置入保证了髂股静脉血栓性疾病治疗的安全性,多种介入技术的综合运用可明显提高疗效.

Application of Comprehensive Interventional Therapy in the Treatment of Iliofemoral Venous Thrombotic Occlusion

Purpose To evaluate the efficacy of inserting inferior vena caval filter, catheter directed thrombolysis, mechanical thrombectomy , percutaneous transluminal angioplasty(PTA) and stent placement in the treatment of Iliofemoral venous thrombotic occlusion. Methods IVC filter was implanted in ten patients of iliofemoral venous thrombotic occlusion (3 of them with pulmonary embolism). Permanent filter was used in 9 cases, and temporal filter in the other. After inserting filter, catheter directed thrombolysis, mechanical thrombectomy, PTA and stent placement were sequentially performed until satisfactory results are achieved. Results All the filters were placed successfully. By the comprehensive use of catheter directed thrombolysis, mechanical thrombectomy, PTA and stent placement, recanalization of the occluded vein and satisfactory results was achieved in 9 of ten patients. One occluded iliofemoral vein could not be crossed with a guide wire and did not receive further treatment. The technical and clinical success rates were 90%. No severe complication occurred. Conclusion The comprehensive use of IVC filter and various interventional technique can improve the safety and effect of the treatment of iliofemoral venous thrombotic occlusion.