[1]吕正佐,王 兵,牛晓阳,等.药物-机械导管溶栓联合Venovo静脉支架植入治疗髂静脉压迫伴急性下肢深静脉血栓形成[J].介入放射学杂志,2024,33(06):627-631.
 LV Zhengzuo,WANG Bing,NIU Xiaoyang,et al.Pharmacomechanical catheter-directed thrombolysis combined with Venovo venous stent implantation in treating iliac vein compression syndrome complicated by acute lower extremity deep venous thrombosis[J].journal interventional radiology,2024,33(06):627-631.
点击复制

药物-机械导管溶栓联合Venovo静脉支架植入治疗髂静脉压迫伴急性下肢深静脉血栓形成()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年06
页码:
627-631
栏目:
临床研究
出版日期:
2024-06-20

文章信息/Info

Title:
Pharmacomechanical catheter-directed thrombolysis combined with Venovo venous stent implantation in treating iliac vein compression syndrome complicated by acute lower extremity deep venous thrombosis
作者:
吕正佐 王 兵 牛晓阳 王 岭 郑浩哲
Author(s):
LV Zhengzuo WANG Bing NIU Xiaoyang WANG Ling ZHENG Haozhe.
Department of Vascular Surgery, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
关键词:
【关键词】 髂静脉压迫综合征 深静脉血栓形成 药物机械导管溶栓 静脉支架置入术 疗效分析
文献标志码:
A
摘要:
【摘要】 目的 评价药物-机械导管溶栓(pharmacomechanical catheter-directed thrombolysis,PCDT)联合Venovo(Bard)静脉支架植入治疗髂静脉压迫综合征(iliac vein compression syndrome,IVCS)伴急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的短期疗效及安全性。方法 回顾性分析2022年7月至2022年12月于郑州大学第五附属医院采用PCDT联合Venovo静脉支架植入治疗IVCS伴急性下肢DVT的23例患者临床资料,评价患者手术前后下肢周径差及术后血栓清除率。于术后第1、3、6个月进行门诊随访,记录患者静脉临床严重程度评分(venous clinical severity score,VCSS)并检查支架通畅情况。结果 所有手术均获成功,靶病变血栓均达到完全清除(清除率>95%),同期植入Venovo髂静脉支架23枚。术后6个月随访期间未见支架发生移位、断裂或脱落等情况,无死亡病例。23例患者下肢患-健侧周径差(大腿、小腿)分别由术前(5.59±0.93) cm、(3.52±0.85) cm下降为术后(1.43±0.68) cm、(1.41±0.72) cm,差异具有统计学意义(均P<0.05)。术后第6个月时VCSS较术前显著降低(5.4±1.1 vs 8.0±1.9,P<0.05),差异具有统计学意义。术后第6个月时一期通畅率为95.7%(22/23),手术再干预率为4.3%。结论 应用PCDT联合Venovo静脉支架植入治疗IVCS伴急性下肢DVT安全有效,具有较好的临床应用前景。

参考文献/References:

[1] May R,Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins[J]. Angiology, 1957, 8: 419- 427.

[2] Jost CJ,Gloviczki P,Cherry KJ Jr, et al. Surgical reconstruction of iliofemoral veins and the inferior vena cava for nonmalignant occlusive disease[J]. J Vasc Surg, 2001, 33: 320- 327.

[3] 利 峰,杨孔武,穆茂媛,等. 介入综合治疗Cockett综合征伴急性左下肢深静脉血栓形成[J]. 介入放射学杂志, 2021, 30:181- 185.

[4] 顾建平,徐 克,滕皋军. 下肢深静脉血栓形成介入治疗规范的专家共识(第2版)[J]. 介入放射学杂志, 2019, 28:1- 10.

[5] Shammas NW, Radaideh Q, Shammas G, et al. Venovo venous stent in treating iliac vein compression: a single- center experience[J]. J Invasive Cardiol, 2021, 33: E677- E680.

[6] Cho H, Kim JW, Hong YS, et al. Stent compression in iliac vein compression syndrome associated with acute Ilio- femoral deep vein thrombosis[J]. Korean J Radiol, 2015, 16: 723- 728.

[7] Knuttinen MG, Naidu S, Oklu R, et al. May- Thurner: diagnosis and endovascular management[J]. Cardiovasc Diagn Ther, 2017, 7: S159- S164.

[8] Mickley V, Schwagierek R, Rilinger N, et al. Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation[J]. J Vasc Surg, 1998, 28: 492- 497.

[9] Xue GH,Huang XZ,Ye M, et al. Catheter- directed thrombolysis and stenting in the treatment of iliac vein compression syndrome with acute iliofemoral deep vein thrombosis: outcome and follow- up[J]. Ann Vasc Surg, 2014, 28: 957- 963.

[10] Cheng L, Zhao H, Zhang FX. Iliac vein compression syndrome in an asymptomatic patient population: a prospective study[J]. Chin Med J(Engl), 2017, 130: 1269- 1275.

[11] Forauer AR,Gemmete JJ,Dasika NL,et al. Intravascular ultrasound in the diagnosis and treatment of iliac vein compression(May- Thurner) syndrome[J]. J Vasc Interv Radiol, 2002, 13: 523- 527.

[12] Tu LK, Nie ML, Fu J, et al. Comparing the efficacy of endovascular treatment for iliac vein compression syndrome with or without acute deep venous thrombosis: a single- center retrospective study[J]. Vascular, 2022, 30: 341- 348.

[13] 樊宝瑞,金泳海,段鹏飞,等. 同期血栓机械清除联合髂静脉支架植入治疗急性下肢深静脉血栓形成12例[J]. 介入放射学杂志, 2017, 26:60- 64.

[14] 彭义盛,楼文胜,顾建平,等. 改良手动抽吸治疗急性髂股静脉血栓形成对照研究[J]. 介入放射学杂志, 2018, 27:510- 515.

[15] Aldag M,Ciloglu U.Combined pharmacomechanical thrombectomy with selective catheter- directed thrombolysis in patients with acute proximal deep vein thrombosis[J]. Turk Gogus Kalp Damar Cerrahisi Derg, 2022, 30: 176- 183.

[16] 赵 辉,胡红耀,饶 珉,等. 经皮机械性血栓清除术同期联合髂静脉支架置入治疗髂静脉压迫综合征并发急性下肢深静脉血栓形成[J]. 临床放射学杂志, 2021, 40:806- 810.

[17] Poyyamoli S,Mehta P,Cherian M,et al. May- Thurner syndrome[J]. Cardiovasc Diagn Ther, 2021, 11:1104- 1111.

[18] Kim HS, Patra A, Paxton BE, et al. Adjunctive percutaneous mechanical thrombectomy for lower- extremity deep vein thrombosis: clinical and economic outcomes[J]. J Vasc Interv Radiol, 2006, 17: 1099- 1104.

[19] 中国医师协会血管外科医师分会静脉学组.常见静脉疾病诊治规范(2022年版)[J]. 中华普通外科学文献(电子版), 2022, 16:255- 272.

[20] 王孝运,段鹏飞,倪才方. 下肢深静脉血栓形成伴髂静脉狭窄支架植入与否近中期临床疗效比较[J]. 介入放射学杂志, 2018, 27:1140- 1143.

[21] McIntee BE. The wallstent endoprosthesis[J]. Gastrointest Endosc Clin N Am, 1999, 9: 373- 381.

[22] Satwah I, Sulakvelidze L, Tran M, et al. Iliac vein stenting is safe when performed in an office based laboratory setting[J]. J Vasc Surg Venous Lymphat Disord, 2022, 10: 60- 67.

[23] Lichtenberg MKW, de Graaf R, Stahlhoff WF, et al. Venovo venous stent in the treatment of non- thrombotic or post- thrombotic iliac vein lesions - short-term results from the Arnsberg venous registry[J]. Vasa, 2019, 48: 175- 180.

[24] Lichtenberg MKW, Stahlhoff WF, Stahlhoff S, et al. Venovo venous stent for treatment of non- thrombotic or post- thrombotic iliac vein lesions- long- term efficacy and safety results from the arnsberg venous registry[J]. Vasa, 2021, 50: 52- 58.

[25] Dabir D,Feisst A,Thomas D,et al. Physical properties of venous stents: an experimental comparison[J]. Cardiovasc Intervent Radiol, 2018, 41: 942- 950.

[26] Sulakvelidze L, Lakhanpal G, Lakhanpal S, et al. A practice audit of short- term outcomes of Wallstents versus Venovo stents for the treatment of nonthrombotic iliac vein outflow stenoses[J]. J Vasc Surg Venous Lymphat Disord, 2023, 11: 357- 364.

 

相似文献/References:

[1]王 颖,张曦彤. 下肢深静脉血栓形成介入治疗后复发的危险因素分析[J].介入放射学杂志,2013,(09):764.
 WANG Ying,ZHANG Xi? tong.. Analysis of the risk factors influencing the recurrence of deep venous thrombosis in lower extremity after interventional treatment[J].journal interventional radiology,2013,(06):764.
[2]樊宝瑞,金泳海,段鹏飞,等.同期血栓机械清除联合髂静脉支架植入治疗急性下肢深静脉血栓形成12例[J].介入放射学杂志,2017,(01):60.
 FAN Bao- rui,JIN Yong- hai,DUAN Peng- fei,et al.Percutaneous mechanical thrombectomy with subsequent iliac vein stent implantation accomplished by single- procedure for acute deep venous thrombosis of lower extremity: preliminary results in 12 cases[J].journal interventional radiology,2017,(06):60.
[3]薛海林,王利伟,王绍娟,等.磁共振静脉造影诊断Cockett综合征的价值[J].介入放射学杂志,2017,(09):783.
 XUE Hailin,WANG Liwei,WANG Shaojuan,et al.Clinical value of magnetic resonance venography in diagnosing Cockett syndrome[J].journal interventional radiology,2017,(06):783.
[4]张 强,李晓光,游国超,等.下腔静脉漂浮血栓介入治疗临床效果[J].介入放射学杂志,2018,27(09):883.
 ZHANG Qiang,LI Xiaoguang,YOU Guochao,et al.Interventional treatment for floating thrombi in inferior vena cava: observation of clinical effect[J].journal interventional radiology,2018,27(06):883.
[5]葛静萍,顾建平,许秀芳,等.妊娠晚期深静脉血栓形成抗凝治疗中改良腹壁皮下注射部位的临床应用[J].介入放射学杂志,2019,28(09):891.
 GE Jingping,GU Jianping,XU Xiufang,et al.Clinical application of modified abdominal subcutaneous injection site in anticoagulant therapy for deep venous thrombosis in late pregnancy female patients[J].journal interventional radiology,2019,28(06):891.
[6]赵 丹,钱 多,倪才方,等.改良式腿围测量专用尺在下肢深静脉血栓形成患者中的临床应用[J].介入放射学杂志,2019,28(12):1202.
 ZHAO Dan,QIAN Duo,NI Caifang,et al.Clinical application of improved special ruler used for the measurement of leg circumference in patients with deep venous thrombosis of lower extremity[J].journal interventional radiology,2019,28(06):1202.
[7]赵刘兵,吕献军,徐 炜,等.双下腔静脉畸形合并左下腔静脉及左下肢深静脉血栓形成介入治疗1例[J].介入放射学杂志,2021,30(06):565.
 ZHAO Liubing,LV Xianjun,XU Wei,et al.Interventional treatment of inferior vena cava duplication malformation complicated by left inferior vena cava thrombosis and left lower extremity deep vein thrombosis: report of one case[J].journal interventional radiology,2021,30(06):565.
[8]刘利国,张秀军.困难滤器回收策略[J].介入放射学杂志,2022,31(09):934.
 LIU Liguo,ZHANG Xiujun..The technical strategy for retrieving difficult-removed indwelling inferior vena cava filtersy[J].journal interventional radiology,2022,31(06):934.

备注/Memo

备注/Memo:

(收稿日期:2023- 05- 10)

(本文编辑:茹 实)

更新日期/Last Update: 2024-06-20