Strijkers Rob H W, ten Cate-Hoek Arina J, Grommes Jochen, Arnoldussen Carsten W K P, Wittens Cees H A
Afd. Vaatchirurgie en CARIM, Maastricht Universitair Medisch Centrum, Maastricht, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(36):A4759.
Despite optimal treatment of acute deep-vein thrombosis (DVT) there is a great chance of recurrent DVT and development of post-thrombotic syndrome (PTS) in the long term. The degree of spontaneous recanalization differs per patient and per thrombus location. 90% of all femoropopliteal occlusions will fully recanalize within 1 year; however, in the case of an iliofemoral thrombosis, recanalization occurs only in a minority of cases. Post-thrombotic complications occur more often following iliofemoral thrombosis, and the chance of recurrent thrombosis is greater than following thrombosis in a more distal location. An anatomical variation or abnormality also more often underlies an iliofemoral thrombosis. It is important to identify patients with a greater chance of developing PTS promptly and to treat them in order to prevent post-thrombotic damage. There are still insufficient trial data available to implement catheter-directed thrombolysis as standard therapy for iliofemoral thrombosis
尽管对急性深静脉血栓形成(DVT)进行了最佳治疗,但长期来看,仍有很大机会出现复发性DVT和血栓形成后综合征(PTS)。自发再通的程度因患者和血栓位置而异。所有股腘静脉闭塞中有90%会在1年内完全再通;然而,在髂股静脉血栓形成的情况下,只有少数病例会发生再通。血栓形成后并发症在髂股静脉血栓形成后更常发生,复发性血栓形成的几率也高于更远端部位的血栓形成。解剖变异或异常也更常是髂股静脉血栓形成的基础。及时识别发生PTS几率较高的患者并对其进行治疗以预防血栓形成后损伤非常重要。目前仍缺乏足够的试验数据来将导管定向溶栓作为髂股静脉血栓形成的标准治疗方法