DeRubertis Brian G, Alktaifi Ali, Jimenez Juan Carlos, Rigberg David, Gelabert Hugh, Lawrence Peter F
Division of Vascular Surgery, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA.
Ann Vasc Surg. 2013 Jul;27(5):577-86. doi: 10.1016/j.avsg.2012.05.024. Epub 2013 Mar 26.
Iliocaval venous lesions produce a spectrum of symptoms ranging from mild swelling to venous ulcerations. In this study we examine the management and outcomes of these patients at our center.
In this study we performed a retrospective analysis of patients with symptomatic iliocaval venous stenoses, occlusions, or venous compression syndromes, who were treated with endovascular intervention during the period 2006-2010.
Of the 36 patients evaluated, mean age was 43.0 years; prior deep venous thrombosis (DVT), pulmonary embolism (PE), and hypercoaguable states were present in 55.5%, 25.0%, and 44.4%, respectively. Patients were stratified by the presence (group I, n = 22) or absence (group II, n = 14) of underlying May-Thurner (MT) syndrome. In group I, 11 patients had nonocclusive MT-related stenoses and 11 had acute DVT with underlying MT, causing pain/swelling (100%), venous claudication (66.7%), or CEAP class 3 (95%) or 6 (5%). Female preponderance was 2.1:1. Eighteen patients had successful intervention (angioplasty/stent with or without lysis), with clinical improvement in 94.4% and a decrease in CEAP score in 83.3%. All group II patients had chronic iliocaval occlusions causing: pain (100%); swelling (88.9%); venous claudication (44.4%); or CEAP class 3 (58%), 4 (25%), or 6 (8%). Recanalization was attempted in all patients and was successful in 71.4%. Successful recanalization was associated with clinical improvement in 88.9% and a decrease in CEAP score in 44.4%. Complications included 2 early reocclusions, 2 hematomas, and no cases of PE or death. Primary and secondary 1-year patency was 86% and 100% overall (mean follow-up 9.6 months). Primary 1-year patency for groups I and II was 87.5% and 83.3%, respectively.
Percutaneous intervention for chronic iliocaval venous lesions is associated with excellent 1-year patency rates and a significant reduction in symptoms and decrease in CEAP score.
髂股静脉病变会引发一系列症状，从轻度肿胀到静脉溃疡不等。在本研究中，我们对本中心这些患者的治疗及结果进行了检查。
在本研究中，我们对2006年至2010年期间接受血管内介入治疗的有症状的髂股静脉狭窄、闭塞或静脉压迫综合征患者进行了回顾性分析。
在评估的36例患者中，平均年龄为43.0岁；既往有深静脉血栓形成（DVT）、肺栓塞（PE）和高凝状态的患者分别占55.5%、25.0%和44.4%。患者根据是否存在潜在的May-Thurner（MT）综合征分为两组（I组，n = 22；II组，n = 14）。在I组中，11例患者有非闭塞性MT相关狭窄，11例有潜在MT的急性DVT，导致疼痛/肿胀（100%）、静脉性跛行（66.7%）或CEAP分级3级（95%）或6级（5%）。女性占优势，比例为2.1:1。18例患者干预成功（血管成形术/支架置入术，伴或不伴溶栓），94.4%的患者临床症状改善，83.3%的患者CEAP评分降低。II组所有患者均有慢性髂股静脉闭塞，导致：疼痛（100%）；肿胀（88.9%）；静脉性跛行（44.4%）；或CEAP分级3级（58%）、4级（25%）或6级（8%）。所有患者均尝试进行再通，71.4%成功。成功再通与88.9%的患者临床症状改善及44.4%的患者CEAP评分降低相关。并发症包括2例早期再闭塞、2例血肿，无PE或死亡病例。总体1年的原发和继发通畅率分别为86%和100%（平均随访9.6个月）。I组和II组1年的原发通畅率分别为87.5%和83.3%。
经皮介入治疗慢性髂股静脉病变的1年通畅率良好，症状显著减轻，CEAP评分降低。
