激光切割镍钛合金大支架植入治疗癌栓所致下腔静脉狭窄的疗效

摘要

目的:探讨对下腔静脉癌栓导致下腔静脉狭窄的患者行激光切割镍钛合金大支架植入治疗的疗效.方法:对20例例下腔静脉癌栓导致下腔静脉狭窄的患者进行激光切割镍钛合金大支架植入治疗,其中17例患者同时接受常规剂量的经导管动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗.对所有患者进行数字减影血管造影(digital subtraction angiography,DSA)检查以观察支架情况,并观察所有患者术前、术后肝功能改变.术后对患者进行随访,观察支架通畅情况及患者生存期.结果:在植入1枚镍钛合金大支架后,所有患者的下腔静脉狭窄均得到缓解.随访19例患者,中位生存期为8.71个月,3、6、12个月生存率分别为89.5%、60%、23.1%;患者术后1个月肝功能与术前肝功能相比无显著差异;所有患者支架均通畅.结论:对下腔静脉癌栓导致下腔静脉狭窄的患者进行激光切割镍钛合金大支架植入治疗后,狭窄开通率高,并且且不会造成支架相关的肝静脉堵塞、急性肝功能衰竭等并发症.%Objective;To evaluate the efficacy of large laser-cut nitinol stcnts in stenosis of the inferior vena cava caused by tumor thrombus. Methods; A total of 20 patients with inferior vena cava stenosis caused by tumor thrombus underwent implantation of large laser-cut nitinol stcnts. 17 cases of them were also treated with conventional transcathctcr arterial chcmocmboli-zation(TACK) . All patients underwent examination of digital subtraction angiography(DSA) and function tests. They were followed up and stcnt patency was assessed. Results: The stenosis of inferior vena cava was dialatcd in all patients after the implantation of a large laser-cut nitinol stcnt. The median survival time of the 19 patients who have been followed up was 8. 71 months. The survival rate was 89. 5% at 3 months* 60% at 6 months and 23. 1% at 12 months . There was no significant change in liver function 1 month after operation. The stcnts were patent in all patients. Conclusions; Implantation of large laser-cut nitinol stcnts is highly effective and safe in treating stenosis of the inferior vena cava caused by tumor thrombus.