Kim In-Sub, Jo Won-Min, Chung Hwan-Hoon, Lee Seung-Hwa
Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University Medical Center, Korea University College of Medicine, Ansan, South Korea.
Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University Medical Center, Korea University College of Medicine, Ansan, South Korea -
Int Angiol. 2018 Feb;37(1):12-18. doi: 10.23736/S0392-9590.17.03825-1. Epub 2017 Mar 14.
May-Thurner syndrome (MTS) has a different etiology from that of general deep vein thrombosis (DVT). However, few clinical comparisons of MTS-induced and non-MTS-induced DVT have been reported. The aim of this study was to analyze the clinical results of pharmaco-mechanical thrombectomy (PMT) in DVT with and without MTS.
Forty-seven iliac vein thrombosis patients treated with PMT between January 2008 and December 2013 were enrolled. 25 patients had DVT with MTS and 22 patients had iliac vein DVT without MTS. We retrospectively reviewed medical records and analyzed mid-term patencies and post-thrombotic syndrome (PTS) occurrence by Villalta Score.
The median follow-up period was 48.4 (36~92) months. A venous stent was inserted in the iliac vein in all MTS patients. One-/two-/three-year primary patencies in the non-MTS group were 77.3% (N.=17) for all three years in the non-MTS group and were 96.0% (N.=24), 83.1% (N.=22), and 83.1% (N.=22) in the MTS group for years 1/2/3, respectively. One-/two-/three-year secondary patencies were 90.9% (N.=20) for all three years in the non-MTS group and were 96.0% (N.=24), 91.4% (N.=23), and 91.4% (N.=23) in the MTS group, respectively. One-, two-, and three-year Villalta Scores were 4.3, 3.9, and 3.4, respectively, in the non-MTS group, and 3.8, 3.7, and 4.0, respectively, in the MTS group. Primary and secondary patency and Villalta Score were not significantly different between the MTS and non-MTS groups.
Although MTS and DVT have different etiologies, clinical results for both diseases using PMT were not significantly different. Therefore, PMT can be offered as an acceptable initial therapy in DVT patients with and without MTS.
May-Thurner综合征（MTS）的病因与一般的深静脉血栓形成（DVT）不同。然而，关于MTS所致DVT与非MTS所致DVT的临床比较报道较少。本研究的目的是分析药物机械性血栓切除术（PMT）治疗伴有和不伴有MTS的DVT的临床结果。
纳入2008年1月至2013年12月期间接受PMT治疗的47例髂静脉血栓形成患者。25例患者为伴有MTS的DVT，22例患者为不伴有MTS的髂静脉DVT。我们回顾性分析病历，并通过Villalta评分分析中期通畅率和血栓形成后综合征（PTS）的发生情况。
中位随访期为48.4（36~92）个月。所有MTS患者均在髂静脉置入了静脉支架。非MTS组1年/2年/3年的原发性通畅率在这三年中均为77.3%（n=17），而MTS组1年/2年/3年的原发性通畅率分别为96.0%（n=24）、83.1%（n=22）和83.1%（n=22）。非MTS组1年/2年/3年的继发性通畅率在这三年中均为90.9%（n=20），而MTS组的继发性通畅率分别为96.0%（n=24）、91.4%（n=23）和91.4%（n=23）。非MTS组1年、2年和3年的Villalta评分分别为4.3、3.9和3.4，MTS组分别为3.8、3.7和4.0。MTS组与非MTS组在原发性和继发性通畅率及Villalta评分方面无显著差异。
虽然MTS和DVT病因不同，但使用PMT治疗这两种疾病的临床结果无显著差异。因此，对于伴有和不伴有MTS的DVT患者，PMT均可作为一种可接受的初始治疗方法。
