Friedrich J M, Hutschenreiter S, Mickley V, Rilinger N, Häberle J, Goldmann A
Radiologische Klinik und Poliklinik, Universität Ulm.
Rofo. 1992 Dec;157(6):591-5. doi: 10.1055/s-2008-1033068.
Among 15 patients with acute thrombotic disease of pelvic veins who had been submitted to operative thrombectomy and creation of arteriovenous fistula in the groin, 12 presented with stenotic lesions 3 months later. These stenoses were submitted to percutaneous angioplasty. If angioplasty failed, percutaneous placement of a vascular stent (wall stent) was performed immediately (n = 7). Stenting in cross-over-technique proved practicable in all cases. Secondary stenotic disease in the exclusively dilated area was observed in 3/5 cases and was also treated with a wall stent. In one patient with recurrent stenoses who refused stenting, extended thrombosis occurred after occlusion of the AV-fistula. At mid-term PTA was successful in only two cases. Intimal hyperplasia was observed in only one wall stent treated patient. Percutaneous treatment of iliacal stenoses in patients with postthrombotic syndrome may be performed safely under the protective effect of the fistula. With the presented technique, patency of pelvic veins could be restored in 11/12 patients with postoperative significant venous stenoses.
在15例患有盆腔静脉急性血栓性疾病且已接受手术血栓切除术并在腹股沟区建立动静脉瘘的患者中，3个月后有12例出现狭窄病变。这些狭窄病变接受了经皮血管成形术治疗。如果血管成形术失败，则立即进行血管支架（壁式支架）的经皮置入（n = 7）。交叉技术置入支架在所有病例中均证明可行。在5例中的3例中观察到仅扩张区域出现继发性狭窄病变，也用壁式支架进行了治疗。在1例复发性狭窄且拒绝置入支架的患者中，动静脉瘘闭塞后发生了广泛血栓形成。中期时，经皮腔内血管成形术仅在2例中成功。仅在1例接受壁式支架治疗的患者中观察到内膜增生。在动静脉瘘的保护作用下，可安全地对血栓形成后综合征患者的髂静脉狭窄进行经皮治疗。采用本技术，12例术后出现明显静脉狭窄的患者中有11例盆腔静脉恢复通畅。
