首页> 中文期刊>心肺血管病杂志 >腔内治疗髂静脉压迫综合征的初步体会(附26例报告)

腔内治疗髂静脉压迫综合征的初步体会(附26例报告)

     

摘要

Objective: Researching the curative effects of endovascular treatment of chronic iliac vein compression syndrome. Methods: Analysing retrospectively the treating results of 26 cases of post-thrombotic syndrome ( PTS) with iliac lesion (PTS group) and primary iliac vein lesion (Non-thrombosis group). Results: 26 cases were treated by balloon dilatation with 5cases of stents placement. Technic successful rate was 100%. Twenty-one cases(81% ) were followed up from 4 to 52 months with average 17 months. Two-year patency rate of stent placement was 100% (5/5). Sixteen cases were performed balloon dilatation only: one-year patency rate of PTS was 67% (4/6) and that of non-thrombosis cases was 100% (10/10) respectively. Symptom and sign relief rate of ache, edema and pigment were 50% ,60% and 0 respectively with PTS cases, that were 45% ,46% and 22% respectively with non-thrombosis cases. Varicosity were not meliorative in all cases. Three cases of ankle ulcer were healed up within 1 month after treatment. Conclusion;endovascular treatment of iliac vein compression syndrome is mini-invasive, safety and effective method. Patency of non-thrombotic cases treated by balloon dilatation only was higher than that of PTS cases. Stents placement is preferred when iliac veins are still obvious residual stenosis after balloon dilatation. There were excellent medium-term patency with stent placement. Venous reflux of lower extremity caused with chronic iliac vein high pressure should be treated appropriately for improving patient's quality of life better.%目的:探讨腔内治疗慢性髂静脉压迫综合征的疗效.方法:总结我院26例血栓后综合征伴髂静脉病变(血栓后综合征组)及原发髂静脉病变(非血栓组)的腔内治疗结果.结果:26例均行球囊扩张术,5例支架置入.技术成功100%.21例(81%)获得随访,随访时间4~52个月,平均17个月.其中支架2年通畅率100%(5/5),单纯球囊扩张16例:血栓后综合征组1年通畅率67%(4/6).非血栓组1年通畅率100%(10/10).症状体征改善率:血栓后综合征组与非血栓组分别为,酸胀50%,45%;下肢肿63%,46%;色素沉着改善率零,22%;2组静脉曲张均无改善;2组踝部溃疡3例均治疗后1个月内愈合.结论:腔内治疗髂静脉压迫综合征是微创、安全及有效的方法,单纯球囊扩张非血栓病例较血栓后遗症病例通畅率高.对于髂静脉狭窄闭塞扩张后仍存在明显狭窄时,支架置入是治疗的首选,中期通畅率高.慢性髂静脉高压所致的下肢静脉反流病变,应做相应处理以进一步提高患者的生活质量.

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