经腘静脉穿刺介入治疗髂股静脉阻塞

目的 探讨经腘静脉穿刺介入治疗髂股静脉阻塞的临床应用价值。方法 对58例髂股静脉阻塞经腘静脉穿刺行综合性介入治疗，其中经导管接触性溶栓术42例，经导管血栓抽吸术25例，机械性血栓清除术49例，球囊扩张腔内成形术41例，支架置入术35例，52例预先放置下腔静脉滤器。平均每人接受5．2项介入治疗。根据造影复查和体征将疗效分为优、良、中、差。出院后继续抗凝治疗1个月，抗血小板治疗6个月。门诊随访6个月时作造影复查。结果腘静脉穿刺技术成功率为96．7％（58／60）。2例腘静脉穿刺失败均为盲穿者。出院时介入治疗疗效：优19例；良30例；中8例；差1例。42例取得6个月随访资料，其中优18例；良20例；中1例；差3例。结论经腘静脉穿刺介入治疗髂股静脉阻塞安全有效。

Interventional treatment of iliofemoral venous obstruction through popliteal vein puncture

Objective To determine the clinical value of popliteal vein puncture in the interventional treatment of iliofemoral venous obstruction. Methods Popliteal vein puncture and synthetic interventioal therapy were performed in 58 cases, including catheter-directed thrombolysis in 42 cases, transcatheter aspiration in 25 cases, thrombectomy in 49 cases, angioplasty in 41 cases, and stenting in 35 cases, and inferior vena cava filter was inserted in 52 cases. The mean kind of interventional therapy performed in each patient was 5.2. The total efficiency was graded on a scale of 1 (excellent), 2 (good), 3 (mild), and 4 (no changes) according to the follow-up venography and physical sign. Anticoagulation therapy for 1 month and antiplatelet for 6 months were performed after dischargement and follow-up venography was performed after six months. Results The technical successful rate of popliteal vein puncture was 96.7% (58/60) . Two popliteal vein puncture failed without ultrasound or fluoroscopy guidance. The efficiency of 58 cases at discharge was as follows: 19 of grade 1, 30 of grade 2, 8 of grade 3, and 1 of grade 4, respectively. 42 cases had six months follow-up data including 18 grade 1, 20 of grade 2, 1 of grade 3, and 3 of grade 4, respectively. Conclusion Interventional treatment of iliofemoral venous obstruction by popliteal vein puncture is safe and effective.