Division of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
J Vasc Interv Radiol. 2012 Aug;23(8):1009-15. doi: 10.1016/j.jvir.2012.04.019. Epub 2012 Jun 13.
To assess retrospectively 30-day, 1-year, and 3-year patency of chronically occluded iliofemoral venous thrombotic lesions treated with stent placement in a case series from a single institution.
Records of 189 consecutive patients treated by interventional radiology for iliofemoral venous occlusions between March 1, 2003, and December 1, 2008, were retrospectively reviewed. A total of 89 patients (27 men; median age, 46.2 y) with chronic iliac or iliofemoral deep vein thrombosis without involvement of the inferior vena cava met criteria for analysis.
All patients (91 limbs) successfully underwent placement of venous self-expanding stents. Patency rate at discharge was 100%. Following the index procedure, mean pressure gradient across the lesion decreased from 5.63 mm Hg (95% CI, 3.51-7.75) to 0.71 mm Hg (95% CI, 0.08-1.34; P < .0001). There were no bleeding complications. Median follow-up was 11.3 months (range, 0.8-72.4 mo). Follow-up at 30 days demonstrated 90 of 91 limbs to be patent. Primary patency rates of treated limbs at 1 and 3 years were 81% and 71%, respectively. Primary patency was lost in 17 cases (19.1%); interventions to maintain or restore stent patency were performed in 13 cases (14.6%). Primary assisted limb patency rates at 1 and 3 years were 94% and 90%, respectively; secondary patency rate was 95%.
Angioplasty with stent placement for treatment of chronically thrombosed iliofemoral veins is a low-risk procedure with acceptable patency rates for as long as 3 years. The outcomes in patients treated in a quaternary referral center are similar to those reported by other centers.
回顾性评估单中心连续病例系列中支架置入治疗慢性闭塞性髂股静脉血栓形成的 30 天、1 年和 3 年通畅率。
回顾性分析 2003 年 3 月 1 日至 2008 年 12 月 1 日期间接受介入放射学治疗髂股静脉闭塞的 189 例连续患者的记录。共有 89 例（27 例男性；中位年龄 46.2 岁）慢性髂股或髂股深静脉血栓形成而不伴有下腔静脉受累符合分析标准。
所有患者（91 条肢体）均成功地进行了静脉自膨式支架置入。出院时通畅率为 100%。在指数手术后，病变处的平均压力梯度从 5.63mmHg（95%CI，3.51-7.75）降至 0.71mmHg（95%CI，0.08-1.34；P<.0001）。无出血并发症。中位随访时间为 11.3 个月（范围，0.8-72.4 个月）。30 天随访显示 91 条肢体中有 90 条通畅。治疗肢体的 1 年和 3 年原发性通畅率分别为 81%和 71%。17 例（19.1%）丧失了原发性通畅性；13 例（14.6%）进行了干预以维持或恢复支架通畅性。1 年和 3 年的原发性辅助肢体通畅率分别为 94%和 90%；二次通畅率为 95%。
对于慢性血栓形成的髂股静脉，血管成形术联合支架置入是一种低风险的治疗方法，最长 3 年的通畅率是可以接受的。在四级转诊中心治疗的患者的结果与其他中心报告的结果相似。
