支架植入术治疗上腔静脉综合征:金属支架的选择  

Stent implantation for the treatment of superior vena cava syndrome : Selection of metallic stents

作　　者：杨维竹[1] 潘恒[1] 黄兢姚[1] 江娜[1] 郑曲彬[1] 林俊清[1] 

机构地区：[1]福建医科大学附属协和医院介入科,福建福州350001

出　　处：《中国介入影像与治疗学》2013年第8期453-456,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨支架植入术治疗上腔静脉综合征(SVCS)中选择金属支架的要点。方法收集51例SVCS,CT均显示上腔静脉(SVC)明显狭窄或闭塞;经股静脉穿刺插管,以球囊扩张狭窄或闭塞段后植入1枚或多枚金属内支架(Smart支架、Z-Stent支架、Fluency支架),直至复查造影显示SVC血流通畅。术后评价疗效。结果 51例SVCS中,50例双侧头臂静脉汇合处受累。支架植入术均获成功,28例植入Smart支架,17例植入Z-Stent,4例植入Fluency支架,2例为Smart支架内套Fluency支架;31例植入1枚支架,12例植入2枚支架,8例植入3枚支架。支架植入后48例临床症状明显改善,上腔静脉压显著下降。术中无SVC破裂等严重并发症发生。46例接受随访,其中18例于随访期内重现SVC阻塞症状,包括11例植入Smart支架、7例植入Z-Stent支架者,植入Fluency支架者未见复发。结论根据SVC病变程度、位置,选择植入结构和特性适当的金属支架可使介入治疗SVCS安全、有效。Objective To investigate the elective points of different types of metallic stents for implantation in patients with superior vena cava syndrome （SVCS）. Methods Fifty-one patients with SVCS were enrolled. Enhanced CT showed obvious stenosis or occlusion of the superior vena cava （SVC） in all patients. Stent implantation was performed after balloon dilatation through femoral vein. One or more stents （Smart stent, Z-Stent and Fluency stent） were positioned till the obstruction of SVC flow was relieved. The therapeutic effects of stent implantation were evaluated. Results Among all 51 patients, invasion of bilateral brachiocephalic veins were observed in 50 patients. Technical success of stent implantation was achieved in all patients including 28 patients with Smart stent, 17 with Z-Stent, 4 with Fluency stent and 2 patients with Fluency＋Smart stent. Significant improvements of SVCS symptoms was noticed in 48 patients after stent implantation, and the pressure of SVC decreased markedly. No serious complication occurred. Forty-six patients underwent follow-up, and SVCS recurred in 18 patients which were treated with Smart stent （n=11） or Z-Stent （n=7） during the follow-up period, while no recurrence was observed in patients treated with Fluency stent. Conclusion According to the extent and location of SVC lesions, selecting metallic stent with appropriate structures and characteristics is important for the safety and efficiency of the interventional treatments of SVCS.

关 键 词：上腔静脉综合征 支架 放射学 介入性 

分 类 号：R543.6[医药卫生—心血管疾病]