Washington University School of Medicine, St. Louis, MO 63110, USA.
J Vasc Interv Radiol. 2012 Sep;23(9):1165-73. doi: 10.1016/j.jvir.2012.06.012. Epub 2012 Jul 28.
To describe the short-term efficacy of a strategy of imaging-guided endovascular intervention for the treatment of patients with established postthrombotic syndrome (PTS).
The medical records of 183 patients with venous disease who were seen in a single interventional radiology clinic were retrospectively reviewed. Study inclusion criteria were (i) endovascular intervention performed to treat established PTS from January 1, 2000, to March 10, 2009; (ii) patient age greater than 18 years; and (iii) availability of follow-up records. A total of 44 patients (20 men, 24 women; mean age, 42.2 y ± 14.1) with PTS who had received 72 interventions (iliac vein stent placement [n = 52] and endovenous laser ablation [EVLA; n = 20]) were identified. A reviewer who did not participate in their care evaluated the follow-up records; recorded the presence or absence of pain, swelling, and active ulceration; and categorized the degree of symptom improvement.
Of 45 treated limbs in 40 patients with available follow-up, complete, partial, or no improvement of overall symptoms was observed in 46.7%, 33.3%, and 20.0%, respectively. The proportions of limbs with pain (35.0% after treatment vs 82.5% before; McNemar test, P < .01) and swelling (50.0% after treatment vs 90.0% before; P < .01) were significantly reduced after treatment with iliac vein stent placement and/or EVLA. Six of seven ulcerated limbs showed significant healing.
The use of an endovascular strategy to treat patients with established PTS was associated with complete or partial symptom relief in 80% of patients at short-term follow-up.
描述一种影像学引导的血管内介入治疗策略治疗已确立的血栓后综合征（PTS）患者的短期疗效。
回顾性分析了在一家介入放射学诊所就诊的 183 例静脉疾病患者的病历。研究纳入标准为：（i）2000 年 1 月 1 日至 2009 年 3 月 10 日期间，因 PTS 而行血管内介入治疗；（ii）患者年龄>18 岁；（iii）具备随访记录。共纳入 44 例 PTS 患者（20 例男性，24 例女性；平均年龄 42.2±14.1 岁），共接受了 72 次介入治疗（髂静脉支架置入术[52 例]和腔内激光消融术[EVLA；20 例]）。一位未参与患者治疗的评估者查阅了随访记录；记录疼痛、肿胀和活动性溃疡的存在或不存在情况，并对症状改善程度进行分类。
在 40 例有随访记录的患者中，45 条治疗肢体中，分别有 46.7%、33.3%和 20.0%的患者整体症状完全、部分或无改善。治疗后疼痛（治疗后 35.0% vs 治疗前 82.5%；McNemar 检验，P<.01）和肿胀（治疗后 50.0% vs 治疗前 90.0%；P<.01）的肢体比例显著降低。7 条溃疡性肢体中，有 6 条显示出明显愈合。
采用血管内策略治疗已确立的 PTS 患者，在短期随访中，80%的患者症状完全或部分缓解。
