摘要
目的比较分析急性下肢深静脉血栓形成(DVT)血栓清除后发现髂静脉狭窄/闭塞是否植入支架的近中期疗效。方法回顾性分析2013年6月至2016年6月收治的60例下肢DVT患者临床资料。所有患者均经导管接触溶栓(CDT)和/或AngioJet机械吸栓清除血栓后造影发现髂静脉狭窄/闭塞,其中32例行髂静脉球囊扩张支架植入术(支架组),28例未予髂静脉球囊扩张支架植入(对照组)。比较两组近期溶栓率、出血并发症发生率、出院前下肢消肿率,中期深静脉通畅率、DVT复发率、髂静脉闭塞率、慢性静脉功能不全调查量表(CIVIQ)评分^([3])及临床表现、病因、解剖和病理生理学(CEAP)分级。结果 60例患者手术均获成功。支架组与对照组溶栓时间、出血并发症发生率差异均无统计学意义(P>0.05),溶栓率、出院前下肢消肿率差异均有统计学意义(P<0.05)。平均随访(20.4±7.8)个月,支架组中期深静脉通畅率、DVT复发率、髂静脉闭塞率、CIVIQ评分、CEAP分级等指标均优于对照组(P<0.05)。结论血栓清除后同期髂静脉球囊扩张支架植入,对提高急性下肢DVT伴髂静脉狭窄/闭塞患者近中期疗效具有重要价值。
Objective To investigate the mid-term effect of stent implantation for iliac vein stenosis/obstruction after catheter-directed thrombosis(CDT) for acute deep venous thrombosis(DVT) of lower extremity. Methods The clinical data of 60 patients with DVT of lower extremity, who were admitted to authors’ hospital during the period from June 2013 to June 2016 to receive treatment, were retrospectively analyzed. CDT and/or mechanical suction with Angiojet to remove thrombus were performed in all patients,and subsequent angiography demonstrated that the iliac vein was stenosed or occluded. The patients were divided into stent group(n=32, using balloon dilatation with stenting of iliac vein) and control group(n=28,not using balloon dilatation with stenting of iliac vein). Short-term thrombolysis rate, incidence of bleeding complication, swelling regression rate of lower limb at the time of discharge, mid-term deep vein patency rate, recurrence rate of DVT, iliac vein occlusion rate, chronic venous insufficiency survey scale(CIVIQ)scores, and the clinical, etiological, anatomical, pathophysiological(CEAP) classification were recorded,and the results were compared between the two groups. Results Successful operation was accomplished in all the 60 patients. No statistically significant differences in thrombolysis time and incidence of bleeding complication existed between the stent group and the control group(P >0.05), while the differences in thrombolysis rate and swelling regression rate of lower limb at the time of discharge between the two groups were statistically significant(P<0.05). The patients were followed up for a mean period of(20.4±7.8) months,and the mid-term deep vein patency rate, recurrence rate of DVT, iliac vein occlusion rate, CIVIQ scores as well as CEAP classification in the stent group were significantly better than those in the control group(P<0.05). Conclusion Balloon dilatation with stenting of iliac vein following CDT has important value in improving the mid-term curative effect of acute DVT of
作者
王孝运
段鹏飞
倪才方
WANG Xiaoyun;DUAN Pengfei;NI Caifang(Department of Interventional Radiology, First Affiliated Hospital, Soochow University,Suzhou, Jiangsu Province 215000, China)
出处
《介入放射学杂志》
CSCD
北大核心
2018年第12期1140-1143,共4页
Journal of Interventional Radiology
关键词
深静脉血栓形成
导管接触溶栓
机械吸栓
髂静脉狭窄
支架植入
深静脉通畅率
deep vein thrombosis
catheter-directed thrombolysis
mechanical suction of thrombus
iliac vein stenosis
stent implantation
deep vein patency rate
