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Long-term efficacy of percutaneous mechanical thrombectomy combined with stent implantation in treatment of acute iliofemoral venous thrombosis |
YU Zuanbiao( ),LIN Zuodong,LANG Dehai*( ) |
Department of Vascular Surgery, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang Province, China |
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Abstract Objective: To evaluate the long-term efficacy of percutaneous mechanical thrombectomy (PMT) combined with stent implantation in treatment of acute iliofemoral vein thrombosis. Methods: Seventy patients with acute iliac vein thrombosis were treated with PMT combined stent implantation in Ningbo No.2 Hospital from November 2015 to November 2017. During the follow-up, the improvement of blood flow was evaluated, the occurrence of post-thrombotic syndrome was assessed by the Villalta rating scale, and the stent patency was examined with lower extremity ultrasound or angiography. Results: The blood flow was significantly improved after procedure in all 70 patients, including 62 cases (88.6%) of grade Ⅲ clearance, 5 cases (7.1%) of grade Ⅱ clearance, and 3 cases (4.3%) of grade Ⅰ clearance. No significant complications occurred during the treatment. The patients were followed up for (15.0±2.5) months. During the follow-up, 64 patients (91.4%) had unobstructed stents, and 9 patients (12.8%) had post-thrombotic syndrome. Conclusion: PMT combined with stent implantation is effective in the treatment of acute iliac vein thrombosis with a high medium-and long-term stent patency rate.
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Received: 05 June 2018
Published: 15 March 2019
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Corresponding Authors:
LANG Dehai
E-mail: 912195864@qq.com;13738868758@139.com
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经皮机械血栓清除联合支架植入治疗急性髂股静脉血栓形成患者中远期疗效评估
目的: 评估经皮机械血栓清除(PMT)联合支架植入治疗急性髂股静脉血栓形成患者的中远期疗效。方法: 收集宁波市第二医院2015年11月至2017年11月因急性髂股静脉血栓形成行PMT联合支架植入70例患者的临床资料,观察支架植入后血流通畅改善情况,术后随访通过Villalta评分量表评估患者血栓后综合征发生情况,并行下肢超声或造影检查评估支架通畅情况。结果: 70例PMT联合髂静脉支架植入患者术后血流均明显改善,血栓Ⅲ级清除62例(88.6%),Ⅱ级清除5例(7.1%),Ⅰ级清除3例(4.3%)。吸栓期间无严重并发症发生。术后平均随访时间为(15.0±2.5)个月,64例(91.4%)患者支架通畅,9例(12.8%)患者出现不同程度的血栓后综合征。结论: PMT联合支架植入治疗急性髂股静脉血栓效果良好,中远期支架通畅率较高。
关键词:
血栓溶解疗法/方法,
髂静脉,
急性病,
静脉血栓形成,
下肢/血液供给,
治疗结果,
支架
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[1] |
COMEROTA A J . Thrombolysis for deep venous thrombosis[J]. J Vasc Surg, 2012, 55 (2): 607- 611
doi: 10.1016/j.jvs.2011.06.005
|
|
|
[2] |
LIN P H , ZHOU W , DARDIK A et al. Catheter-direct thrombolysis versus pharmacomechanicalthrombectomy for treatment of symptomatic lower extremity deep venous thrombosis[J]. Am J Surg, 2006, 192 (6): 782- 788
doi: 10.1016/j.amjsurg.2006.08.045
|
|
|
[3] |
HAGER E , YUO T , AVGERINOS E et al. Anatomic and functional outcomes of pharmacomechanical and catheter-directed thrombolysis of iliofemoral deep venous thrombosis[J]. J Vasc Surg Venous Lymphat Disord, 2014, 2 (3): 246- 252
doi: 10.1016/j.jvsv.2014.02.003
|
|
|
[4] |
GARCIA M J , LOOKSTEIN R , MALHOTRA R et al. Endovascular management of deep vein thrombosis with rheolyticthrombectomy:final report of the prospective multicenter PEARL (Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths) registry[J]. J Vasc Interv Radiol, 2015, 26 (6): 777- 785
doi: 10.1016/j.jvir.2015.01.036
|
|
|
[5] |
PARK K M , MOON I S , KIM J I et al. Mechanical thrombectomy with Trerotola compared with catheter-directed thrombolysis for treatment of acute iliofemoral deep vein thrombosis[J]. Ann Vasc Surg, 2014, 28 (8): 1853- 1861
doi: 10.1016/j.avsg.2014.06.056
|
|
|
[6] |
BLACKWOOD S , DIETZEK A M . Pharmacomechanical thrombectomy:2015 update[J]. Expert Rev Cardiovasc Ther, 2016, 14 (4): 463- 475
doi: 10.1586/14779072.2016.1140038
|
|
|
[7] |
HUANG C Y , HSU H L , KUO T T et al. Percutaneous pharmacomechanical thrombectomy offers lower risk of post-thrombotic syndrome than catheter-directed thrombolysis in patients with acute deep vein thrombosis of the lower limb[J]. Ann Vasc Surg, 2015, 29 (5): 995- 1002
doi: 10.1016/j.avsg.2015.01.014
|
|
|
[8] |
中华医学会放射学分会介入学组 . 下腔静脉滤器置入术和取出术规范的专家共识[J]. 介入放射学杂志, 2011, 20 (5): 340- 344 Chinese Medical Association Radiology Branch Interventional Group . Expert consensus on the specification of inferior vena cava filter placement and removal[J]. Journal of Interventional Radiology, 2011, 20 (5): 340- 344
doi: 10.3969/j.issn.1008-794X.2011.05.003
|
|
|
[9] |
《血管与腔内血管外科杂志》编辑部, 下肢静脉疾病外科治疗专家协作组 . AngioJet机械血栓清除术治疗急性下肢深静脉血栓形成的专家共识(2016版)[J]. 血管与腔内血管外科杂志, 2017, 3 (1): 555- 558 Editorial department of Journal of Vascular and Endovascular Surgery , The panel of Venous diseases of lower extremity surgical treatment specialists . Recommendations of percutaneous mechanical thrombectomy in the treatment of acute deep vein thrombosis of lower extremity(2016 Edition)[J]. Journal of Vascular and Endovascular Surgery, 2017, 3 (1): 555- 558
|
|
|
[10] |
LIN P H , ZHOU W , DARDIK A et al. Catheter-direct thrombolysis versus pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis[J]. Am J Surg, 2006, 192 (6): 782- 788
doi: 10.1016/j.amjsurg.2006.08.045
|
|
|
[11] |
KAHN S R , PARTSCH H , VEDANTHAM S et al. Definition of post-thrombotic syndrome of the leg for use in clinical investigations:a recommendation for standardization[J]. J Thromb Haemost, 2009, 7 (5): 879- 883
doi: 10.1111/jth.2009.7.issue-5
|
|
|
[12] |
NEGLéN P , HOLLIS K C , OLIVIER J et al. Stenting of the venous outflow in chronic venous disease:long-term stent-related outcome, clinical, and hemodynamic result[J]. J Vasc Surg, 2007, 46 (5): 979- 990
doi: 10.1016/j.jvs.2007.06.046
|
|
|
[13] |
MURPHY E H , JOHNS B , VARNEY E et al. Deep venous thrombosis associated with caval extension of iliac stents[J]. J Vasc Surg Venous Lymphat Disord, 2017, 5 (1): 8- 17
doi: 10.1016/j.jvsv.2016.09.002
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