左髂静脉狭窄或闭塞的介入治疗

目的 探讨介入治疗左髂静脉狭窄或闭塞在左髂静脉受压综合征治疗上的地位和意义.方法 经股静脉行左髂总静脉病变介入治疗316例,189例二期行左大隐静脉高位结扎、抽剥术,82例加做左股静脉瓣膜缩窄术.随访231例,时间6～120个月(平均52个月),均做彩超检查,116例静脉顺行造影.结果 球囊扩张成功305例,髂静脉内置支架272例,无死亡和肺动脉栓塞.随访结果,98.5%的患者静脉曲张消失,93.7%肿胀消失或明显缓解,74%溃疡愈合,术后三年彩超检查见5.34%的患者支架内血栓或狭窄,造影见5.4%的患者支架内血栓阻塞.结论 左髂静脉狭窄或闭塞的介入治疗远期效果良好.

Interventional therapy for left iliac vein stenosis or occlusion

Objective To evaluate interventional therapy for left iliac vein stenosis or occlusion (left iliac vein compressed syndrome or Cokkett syndrome).Method In this study 316 cases received interventional therapy for left iliac common vein lesions,189 cases underwent staged saphenous vein high ligation and stripping,and 82 cases received external prosthetic sleeve valvuloplasty.Two hundred and thirty-one cases were followed up from 6 to 120 months(average 52 months),with all cases being evaluated by colour ultrasound,and among those 116 cases received venography.Results The stenosis or occlusive segments of left iliac vein were successfully dilated in 305 cases,of which 272 cases received stents implanting therapy.There was no inhospital mortality nor pulmonary embolism.According to following up results.the symptom of varicose vein disappeared in about 95.8%patients.and the symptom of leg swelling disappeared or dramatically relieved in about 95.7%cases.among which 74%leg ulcers were completely healed.Stents were occluded by thrombus during venography in about 5.4%. Conclusions The long term result of interventional therapy is satisfactory for left iliac vein stenosis or occlusion caused by Cockett syndrome.