Chang Kevin Z, Likes Kendall, Demos Jasmine, Black James H, Freischlag Julie A
Division of Vascular and Endovascular Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA.
Vasc Endovascular Surg. 2012 Jan;46(1):15-20. doi: 10.1177/1538574411423982. Epub 2011 Dec 8.
To assess the role of postoperative venography in patients treated with first rib resection and scalenectomy (FRRS) for effort thrombosis, a retrospective review was done to evaluate long-term venous patency in 84 patients treated at the Johns Hopkins Medical Institutions. Patients undergo venography 2 weeks postoperatively. If there is >50% stenosis, the subclavian vein is dilated and the patient receives anticoagulation. If the vein is occluded, patients are maintained on anticoagulation. Of the 85 patients, 21 patients had patent veins, 47 patients had stenotic veins, and 16 patients had chronically occluded veins. In follow-up, symptomatic restenosis was seen in 3 patients and those veins were redilated. Two other patients had late occlusions at 23 and 63 months and received anticoagulation and redilatation, respectively. Using venography to guide postoperative management, 79 of 84 patients had patent veins many years postoperatively. Long-term patency, as seen by duplex scan, was achieved in nearly all patients using this protocol.
为评估第一肋切除术和斜角肌切除术（FRRS）治疗胸廓出口综合征患者术后静脉造影的作用，我们进行了一项回顾性研究，以评估约翰霍普金斯医疗机构治疗的84例患者的长期静脉通畅情况。患者在术后2周接受静脉造影。如果狭窄>50%，则扩张锁骨下静脉并给予患者抗凝治疗。如果静脉闭塞，则维持患者的抗凝治疗。85例患者中，21例静脉通畅，47例静脉狭窄，16例静脉长期闭塞。随访中，3例患者出现有症状的再狭窄，这些静脉再次扩张。另外2例患者分别在23个月和63个月出现晚期闭塞，并分别接受了抗凝和再次扩张治疗。使用静脉造影指导术后管理，84例患者中有79例在术后多年静脉通畅。通过这种方案，几乎所有患者通过双功扫描都实现了长期通畅。
