Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
Cardiovasc Intervent Radiol. 2011 Jun;34(3):542-9. doi: 10.1007/s00270-010-9927-6. Epub 2010 Jul 1.
Venous stenting has been shown to effectively treat iliofemoral venous obstruction with good short- and mid-term results. The aim of this study was to investigate long-term clinical outcome and stent patency. Twenty patients were treated with venous stenting for benign disease at our institution between 1987 and 2005. Fifteen of 20 patients (15 female, mean age at time of stent implantation 38 years [range 18-66]) returned for a clinical visit, a plain X-ray of the stent, and a Duplex ultrasound. Four patients were lost to follow-up, and one patient died 277 months after stent placement although a good clinical result was documented 267 months after stent placement. Mean follow-up after stent placement was 167.8 months (13.9 years) (range 71 (6 years) to 267 months [22 years]). No patient needed an additional venous intervention after stent implantation. No significant difference between the circumference of the thigh on the stented side (mean 55.1 cm [range 47.0-70.0]) compared with the contralateral thigh (mean 54.9 cm [range 47.0-70.0]) (p=0.684) was seen. There was a nonsignificant trend toward higher flow velocities within the stent (mean 30.8 cm/s [range 10.0-48.0]) and the corresponding vein segment on the contralateral side (mean 25.2 cm/s [range 12.0-47.0]) (p=0.065). Stent integrity was confirmed in 14 of 15 cases. Only one stent showed a fracture, as documented on x-ray, without any impairment of flow. Venous stenting using Wallstents showed excellent long-term clinical outcome and primary patency rate.
静脉支架置入术已被证实可有效治疗髂股静脉阻塞,且具有良好的短期和中期效果。本研究旨在探讨长期临床结果和支架通畅率。1987 年至 2005 年间,我院对 20 例良性疾病患者行静脉支架置入术。20 例患者中 15 例(15 例女性,支架置入时的平均年龄为 38 岁[范围 18-66 岁])返回进行临床访视、支架平片和双功超声检查。4 例患者失访,1 例患者在支架置入后 277 个月死亡,尽管在支架置入后 267 个月记录到良好的临床结果。支架置入后平均随访时间为 167.8 个月(13.9 年)(范围 71(6 年)至 267 个月[22 年])。支架置入后,无患者需要进一步静脉介入治疗。支架置入侧大腿周长(平均 55.1cm[范围 47.0-70.0])与对侧大腿周长(平均 54.9cm[范围 47.0-70.0])相比无显著差异(p=0.684)。支架内和对侧相应静脉段的血流速度均有升高趋势,但无统计学意义(支架内平均 30.8cm/s[范围 10.0-48.0],对侧平均 25.2cm/s[范围 12.0-47.0])(p=0.065)。15 例中的 14 例证实支架完整。仅 1 例支架显示骨折,X 线显示无血流受限。Wallstent 静脉支架置入术具有优异的长期临床效果和初始通畅率。