微创治疗髂静脉闭塞合并下肢深静脉血栓形成  

Minimally invasive treatment of common iliac vein occlusion combined with lower extremity deep venous thrombosis

作　　者：张希全[1] 王义平[1] 朱伟[1] 李长海[1] 郭锋[1] 董戈[1] 张清[1] 

机构地区：[1]中国人民解放军第148医院介入血管科全军腔内介入诊疗中心,山东淄博255300

出　　处：《中国介入影像与治疗学》2012年第12期843-846,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨机械性抽吸联合支架植入术治疗髂静脉闭塞合并下肢深静脉血栓(LEDVT)的临床应用价值。方法收集273例髂静脉闭塞合并急性LEDVT患者,经皮穿刺股静脉置入滤器,插入8～14F鞘管后抽吸血栓。清除髂、股静脉血栓后,对造影显示血管狭窄或闭塞段行经皮腔内血管成形术(PTA)和支架植入,对髂静脉闭塞合并混合型LEDVT行辅助溶栓治疗。结果 219例(219/273,80.22%)血栓完全清除(Ⅲ级),49例(49/273,17.95%)部分清除(Ⅱ级),5例(5/273,1.83%)少量清除(Ⅰ级)。PTA和支架植入术后治愈235例(235/273,86.08%),显效29例(29/273,10.62%),好转7例(7/273,2.56%),无效2例(2/273,0.73%)。随访3～6、7～12、18～24、25～36个月,支架通畅率分别为94.87%(259/273)、93.73%(254/271)、87.08%(236/271)、84.13%(228/271)。结论机械性抽吸联合支架植入术治疗髂静脉闭塞合并急性LEDVT疗程较短,安全有效。Objective To observe the clinical value of mechanical aspiration combined with stenting for common iliac vein occlusion with lower extremity deep venous thrombosis （LEDVT）. Methods Totally 273 patients with common lilac vein occlusion and LEDVT were collected. All patients underwent local anesthesia and percutaneous puncture of femoral vein. IVC filters was placed, and 8--14F catheter was inserted to aspirate the thrombus. After iliac venous thrombus was elimi- nated, percutaneous transluminal angioplasty （PTA） and stenting were performed when venography showed common iliac vein stenosis or occlusion. Patients with LEDVT underwent thrombolysis treatment. Results Completely thrombus clearing （degree Ⅲ） was found in 219 patients （219/273, 80.22%）, partly clearing （degree Ⅱ） in 49 （49/273, 17.95%）, while minimal clearing was found in （degree Ⅰ） 5 （5/273, 1.83%） patients. After stent implantation, 235 （235/273, 86.08%） patients were cured, excellent and good therapeutic effect were obtained in 29 （29/273, 10.62 %） and 7 （7/273, 2.56%） patients, respectively, whereas the effect was invalid in 2 （2/273, 0.73%） patients . The follow-up of stent pa- tency rate during 3-6 months, 7-12 months, 18-24 months and 25-36 months was 94. 87% （259/273）, 93.73% （254/271）, 87.08% （236/271）, and 84.13% （228/271）, respectively. Conclusion Mechanical aspiration combined with stenting for common iliac vein occlusion with LEDVT has notable therapeutic effect and short duration.

关 键 词：静脉血栓形成 下肢 介入治疗 血栓抽吸 

分 类 号：R543.6[医药卫生—心血管疾病]