摘要
目的探讨滤器相关下腔静脉血栓形成(IVCT)血管腔内治疗的效果。方法回顾性分析2012年1月至2016年4月在本中心行腔内治疗的46例滤器相关IVCT患者的临床资料。结果 46例患者的总体靶血管开通的技术成功率为86.9%。40例患者成功开通下腔静脉滤器闭塞段到单侧/双侧髂股静脉闭塞段,手术操作的平均时间为(2.0±0.3)h。所有患者在治疗过程中没有置入新的下腔静脉滤器,围术期死亡率为0,没有出现严重的出血及肺动脉栓塞情况,无腔内手术相关的并发症发生。患者的平均住院时间为(6±2)d,腔内治疗的总体临床症状缓解率为92.5%。39例(84.8%)患者获得随访,平均随访时间19个月。随访显示下腔静脉滤器以及植入的支架形态学良好,未出现支架或滤器断裂,血管壁刺破等情况。术后12个月下腔静脉及髂股静脉内支架内再狭窄率为7.7%。结论结合抗凝治疗的腔内治疗对于滤器相关IVCT具有满意的疗效,但是在血管开通的技术成功率和远期通畅率等方面,仍有进一步的提高。
Objective To investigate the effect of endovascular treatment of filter-related inferior vena cava thrombosis（IVCT）. Methods The clinical data of 46 patients with filter-related IVCT associated with endovascular treatment in our department from January 2012 to April 2016 were analyzed retrospectively. Results The overall the technical success recanalizing rate of target vessel in 46 patients was 86.9%. In 40 patients, the occlusion of the vessel was successfully recanalized from inferior vena cava filter to the unilateral/bilateral iliofemoral veins. The mean operation time was（2±0.3） hours. All patients were not implanted with a new inferior vena cava filter during the course of treatment. The perioperative mortality was 0. No serious bleeding and pulmonary embolism occurred. No surgery-related complications occurred. The average hospitalization time in 46 patients was（6 ±2） days, and the overall symptom remission rate was 92.5%. 39 patients（84.8%） were followed up for an average of 19 months. The deep venography of the lower extremities showed that the inferior vena cava filter and the implanted stents had a good morphology with no stents or filters fracture and punctured vessel wall. The rate of restenosis was 7.7%in the inferior vena cava and iliac vein stent in 12 months after operation. Conclusions Endovascular treatment with anticoagulant therapy has a satisfactory therapeutic effect on filter-related IVCT, but there is still further improvement in the technical success rate and the graft patency rate of vascular recanalization.
作者
崔超毅
殷敏毅
黄新天
李维敏
陆民
杨广林
黄晟
蒋米尔
陆信武
刘晓兵
CUI Chao-yi, YIN Min-yi, HUANG Xin-tian, LI Wei-min, LU Min, YANG Guang-lin, HUANG Sheng, JIANG Mi-er, LU Xin-wu, LIU Xiao-bin,(Department of Vascular Surgery, the Ninth People＇s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, Chin)
出处
《中国血管外科杂志（电子版）》
2018年第1期16-19,23,共5页
Chinese Journal of Vascular Surgery(Electronic Version)
基金
上海交通大学医学院附属第九人民医院基础研究助推计划(JYZZ004)
关键词
下腔静脉血栓形成
腔内治疗
抗凝治疗
Inferior vena cava thrombosis
Endovascular treatment
Anticoagulant therapy
