单中心Wallstent支架治疗髂静脉压迫综合征中期疗效分析  

The midterm effect of Wallstent implantation for treatment of the iliac vein compress syndrome

作　　者：艾文佳[1] 林少芒[1] 蔡欢 张智辉[1] 萧剑彬[1] 李强[1] 李阳勇[1] 刘金玲[1] Ai Wenjia;Lin Shaomang;Cai Huan;Zhang Zhihui;Xiao Jianbin;Li Qiang;Li Yangyong;Liu Jinling(Department of Vascular Surgery,The Second Affiliated Hospital,Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院血管外科,广州510260

出　　处：《中华血管外科杂志》2021年第3期188-192,共5页Chinese Journal of Vascular Surgery

基　　金：广东省医学科学基金(A2020317);广州医科大学附属第二医院项目基金(020Q055042)。

摘　　要：目的探讨Wallstent支架治疗髂静脉压迫综合征(IVCS)中期疗效。方法回顾性分析2013年1月至2019年7月广州医科大学附属第二医院血管外科采用Wallstent支架植入治疗并有完整随访资料的112例IVCS患者(排除活动性肿瘤)的临床资料。其中左下肢97例,右下肢12例,双下肢3例;跨关节26例。分为非血栓组(26例)、急性或亚急性血栓组(65例)及慢性血栓组(21例),所有患者术后规则抗凝治疗3个月以上,统计分析术后支架通畅率及相关并发症情况。结果112例患者中,植入支架149枚。随访(38.4±9.8)个月,支架内再狭窄或闭塞9例。支架一期通畅率92.0%(103/112),其中急性亚急性血栓组92.3%(60/65),慢性血栓组85.7%(18/21),非血栓组96.2%(25/26);支架二期通畅率95.5%(107/112),其中急性亚急性血栓组96.9%(63/65),慢性血栓组85.7%(18/21),非血栓组100%(26/26)。无支架脱落、植入血管破裂、严重出血等并发症;1例对侧髂静脉继发血栓。结论IVCS应用Wallstent编织支架治疗,具有较高的技术成功率和支架中期通畅率,较低的并发症发生率。Objective To investigate the midterm efficacy of Wallstent implantation for the treatment of iliac vein compress syndrome(IVCS).Methods A retrospective study was performed on the clinical data of 112 IVCS patients(excluding those with active tumors)treated with Wallstent implantation with complete follow-up data at the Department of Vascular Surgery of the Second Affiliated Hospital of Guangzhou Medical University from January 2013 to July 2019.Including 97 cases of left lower extremities,12 cases of right lower extremities and 3 cases of bilateral lower extremities.Twenty-six cases were trans-articular.All patients were divided into the non-thrombosis group(26 cases),the acute and subacute thrombosis group(65 cases)and the chronic thrombosis group(21 cases).All the patients received regular postoperative anticoagulant therapy for more than 3 months.The patency rate of stent and related complications were recorded and analyzed.Results For a total of 112 patients,149 stents were implanted.During the follow-up of(38.4±9.8)months,the primary patency rate of stent was 92.0%(103/112),including 92.3%(60/65)in the acute and subacute thrombosis group,85.7%(18/21)in the chronic thrombosis group and 96.2%(25/26)in the non-thrombosis group respectively while the secondary patency rate of stent was 95.5%(107/112),including 96.9%(63/65)in the acute and subacute thrombosis group,85.7%(18/21)in the chronic thrombosis group and 100.0%(26/26)in the non-thrombosis group.There were no severe complications such as dislocation or fracture of stent and rupture and major bleeding of implanted blood vessel.One patient underwent secondary contralateral iliac vein thrombosis.Conclusion Wallstent implantation for the treatment of IVCS has a high rate of technical success,a high rate of midterm patency and a low rate of complications.

关 键 词：Wallstent 支架 髂静脉压迫综合征 疗效 

分 类 号：R654.4[医药卫生—外科学]