血管腔内介入治疗髂静脉压迫综合征45例分析

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Abstract Objective: To investigate the clinical effect of endovascular interventional treatment for iliac vein compression syndrome (IVCS). Methods: The data of 45 patients with IVCS, underwent interventional treatment from April 2008 to April 2015 in our hospital, were analyzed retrospectively. Among these patients, 38 cases complicated with lower extremity varicose veins, underwent stenting in 37 cases and iliac venous balloon dilation in 1 case. Complicated with post-thrombotic syndrome (PTS) in 6 cases, underwent stenting in 5 cases and iliac venous balloon dilation in 1 case. Complicated with acute deep venous thrombosis (DVT) in 3 cases, underwent catheter directed thrombolysis (CDT) and then stenting in 2 cases, underwent CDT with balloon dilatation in 1 case. All the stents were self-expanding stent. The stenosis rate of iliac vein and the perimeter difference between the suffered limb and healthy one were measured before and after operation. The patients were followed up with Duplex ultrasound in 1-, 3-, 6-month, 1-, and 2- year postoperatively, respectively. Results: A total of 47 stents were placed in 45 patients. The diameter and the length of stent was 6 to 14 mm (mean 12.7±2.7 mm) and 40-200 mm (mean 64.3±39.4 mm), respectively. CDT after inferior vena cava filtration in 3 cases with DVT, using urokinase with a dose of 240 to 480 (mean 400±138.6) million U for 4 to 8 (mean 6.7) days, without the recurrence of pulmonary embolism. The difference of iliac venous stenosis was statistically significant [89.8%±8.2% (70.0%-100.0%) vs 4.0%±12.1% (0-70.0%), P<0.01]. Perimeter differences of thigh and calf between the suffered limb and healthy one were significant before and after operation, too (P<0.001). The patency rates of 1-, 3-, 6- months, 1- and 2- year were 95.5%, 93.2%, 93.2%, 90.6% and 90.6%, respectively. Four patients (8.9%) suffered minor bleeding at puncture site and were treated with compression successfully. The only 1 patients (2.2%) underwent stenting of right iliac vein, complicated migration stent to the right ventricle, and arrested by Amplatz Goose Neck Snare and Kit, successfully. The incidence of PTS was 8.9% (4/45) during the follow-up of 1 to 24 (mean 16.8) months, caused by iliac venous occlusion in different periods. Conclusion: Interventional therapy for patients of IVCS is safe and effective. It is satisfactory of stent placement for IVCS.

Key words： iliac vein compression syndrome deep vein thrombosis stent catheter directed thrombolysis

Received: 05 June 2015

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	HUANG Chongqing1
	YU Guanfeng1
	HUANG Jingyong1
	JIN Hao2.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I12/902

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