Zhang Qingqiao, Huang Qianxin, Shen Bin, Sun Jingmin, Wang Xiaolong, Liu Hongtao
Department of Interventional Radiology and Vascular Surgery, The Affiliated Hospital of Xuzhou Medical College, No. 99 Huaihai West Road, Xuzhou, 221006, Jiangsu province, China,
Cardiovasc Intervent Radiol. 2015 Jun;38(3):665-71. doi: 10.1007/s00270-014-0980-4. Epub 2014 Sep 11.
This study was designed to investigate the safety and efficacy of endovascular intervention for the treatment of primary entire-inferior vena cava (IVC) occlusion.
Endovascular interventions were performed in six patients for the treatment of primary entire-IVC occlusion. IVC and hepatic venography were performed via the jugular and femoral veins. Balloon angioplasty was used to revascularize the hepatic vein and IVC and a stent was placed in the IVC to maintain patency. Postoperative color Doppler ultrasonography was performed at 1, 3, 6, and 12 months, and then annually, to monitor the patency of the hepatic vein and IVC.
The IVC and one or two hepatic veins were successfully revascularized in five patients. Revascularization was successful in the right and left hepatic veins in one patient; however, IVC patency could not be established in this patient. Eleven Z-type, self-expanding stents were placed into the IVCs of five patients (three stents in two patients, two stents in two patients, and one stent in one patient). There were no instances of postoperative bleeding or mortality. Follow-up was conducted for 18-90 months (42.8 ± 26.5 months). None of the five patients suffered restenosis of the IVC or hepatic veins. However, there was one of the six cases of right hepatic vein restenosis at 18 months postprocedure that was revascularized after a second balloon dilatation.
Endovascular intervention is safe and efficacious for the treatment of primary entire-IVC occlusion.
本研究旨在探讨血管内介入治疗原发性下腔静脉完全闭塞的安全性和有效性。
对6例原发性下腔静脉完全闭塞患者进行血管内介入治疗。通过颈静脉和股静脉进行下腔静脉和肝静脉造影。采用球囊血管成形术使肝静脉和下腔静脉再通，并在下腔静脉置入支架以维持通畅。术后1、3、6和12个月以及之后每年进行彩色多普勒超声检查，以监测肝静脉和下腔静脉的通畅情况。
5例患者的下腔静脉和1条或2条肝静脉成功再通。1例患者的左右肝静脉均成功再通；然而，该患者的下腔静脉未能建立通畅。5例患者的下腔静脉共置入11枚Z型自膨式支架（2例患者置入3枚支架，2例患者置入2枚支架，1例患者置入1枚支架）。术后无出血或死亡病例。随访18 - 90个月（42.8±26.5个月）。5例患者均未发生下腔静脉或肝静脉再狭窄。然而，6例中有1例在术后18个月出现右肝静脉再狭窄，经再次球囊扩张后实现再通。
血管内介入治疗原发性下腔静脉完全闭塞安全有效。
