[Endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound]
- PMID: 31826585
- DOI: 10.3760/cma.j.issn.0376-2491.2019.46.008
[Endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound]
Abstract
Objective: To evaluate the clinical efficacy of endovascular treatment for non-thrombotic right iliac vein compression syndrome with intravascular ultrasound. Methods: The clinical data of 40 patients with non-thrombotic right iliac vein compression syndromereceiving intravascular ultrasound-assisted balloon dilatation combined with stent implantation from January 2012 to December 2018 were retrospectively analyzed. There were 32 males and 8 females, the average age of whom was 63 (46-81) years old. The patients were classified according to the CEAP (Clinical-Etiology- Anatomy-Pathophysiology) classification: 7 cases as C3, 18 as C4, 10 as C5 and 5 as C6. All patients underwent percutaneous right femoral vein puncture, intravascular ultrasound, and balloon dilatation combined with stentimplantation in the right iliac vein lesion location. Results: The success rate of clinical operations was 100%. There were no serious complications during the perioperative period. All patients were followed up for 4-58 months. During the follow-up period, the relief rate of limb edema was 88.6% (31/35), the pain relief rate was 86.7%(13/15), and the healing rate of ulcers was 100% (6/6). After the stent implantation, the endovascular area of the compression site was significantly enlarged (34.5mm(2)± 11.1mm(2)vs129.8 mm(2)±17.2 mm(2), P<0.001). The follow-up of color Doppler and/or anterograde angiography for deep veins of lower limb with digital subtraction angiography showed that the blood flow in the stentsweres mooth in all patients. Three cases were observed that the intimal hyperplasia led to mild in-stent restenosis, no obvious in stent restenosis (>50%). The abdominal X-ray plain film showed no obvious displacement and fracture of the stents. The venous clinical severity score (VCSS) was statistically significant (13.0±2.4 vs 6.2±2.0, P<0.001). The statistical results of short-form health surver SF-36 showed that the scores of life quality in all dimensions of the affected limb were significantly improved after operation (P=0.000). Conclusion: Intravascular ultrasound-assisted balloon dilatation combined with stent implantation is not only a safe and effective treatment for non-thrombotic right iliac vein compression syndrome, but also has a good mid-term patency rate.
目的： 探讨腔内超声辅助下血管腔内治疗非血栓性右髂静脉受压综合征的临床疗效。 方法： 回顾性分析2012年1月至2018年12月在苏州大学附属第二医院血管外科住院的40例非血栓性右髂静脉受压综合征患者在腔内超声辅助下行球囊扩张联合支架植入术的临床资料。其中男32例，女8例，平均年龄63（46~81）岁。按临床表现-病因学因素-病变解剖部位-病因学因素（CEAP）分级：C3级7例，C4级18例，C5级10例，C6级5例。所有患者接受经皮右股静脉穿刺，血管腔内超声检查及右髂静脉病变段球囊扩张联合支架植入术。 结果： 临床技术成功率为100%。围手术期无严重并发症。随访时间（34±12）（4~58）个月。随访期间，患肢肿胀缓解率88.6%（31/35），疼痛缓解率86.7%（13/15），溃疡治愈率100%（6/6）。支架植入后受压部位血管腔内面积明显扩大[（34.5±11.1）mm(2)与（129.8±17.2）mm(2)，P<0.001]。彩色多普勒和/或数字减影血管造影（DSA）下肢静脉顺行造影随访见所有患者支架内血流通畅，3例血管内膜增生导致轻度支架内再狭窄，未见明显支架内再狭窄（>50%）。腹部X线平片未见支架明显移位和断裂现象。患肢手术前后静脉临床危重程度评分（VCSS）差异有统计学意义（13.0±2.4与6.2±2.0，P<0.001）；健康调查简表（SF-36）统计提示术后患肢各维度生活质量评分明显提高（P=0.000）。 结论： 腔内超声辅助下球囊扩张联合支架植入治疗非血栓性右髂静脉受压综合征不仅安全有效，而且具有良好的中期通畅率。.
Keywords: Angioplasty; Endovascular treatment; Iliac vein compression syndrome; Intravascular ultrasound; Stent.
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