Iyer Sunil, Angle John F, Uflacker Andre, Sharma Aditya M
Division of Cardiovascular Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
Department of Radiology, University of Virginia School of Medicine, Charlottesville, VA, USA.
Curr Treat Options Cardiovasc Med. 2017 Jun;19(6):45. doi: 10.1007/s11936-017-0541-7.
Venous compression syndromes present a diagnostic and therapeutic challenge as the clinical presentation can be vague, diagnostic criteria are often not present, and high quality standardization of when and how to treat is not available in part due to the limited number of cases reported and also due to the limited literature available. Significant venous compression should be considered when clinical symptoms correlate to location of compression and there is evidence of hemodynamic changes including venous hypertension, collateral/variceal formation, and/or thrombus formation. In general, treatment of venous compression should address the etiology of the compression as opposed to just treating symptoms associated with it such as significant varices or anticoagulation for thrombus to avoid recurrence of symptoms.
静脉压迫综合征带来了诊断和治疗方面的挑战,因为临床表现可能模糊不清,诊断标准常常不存在,而且何时以及如何治疗的高质量标准化方法也不存在,部分原因是报告的病例数量有限,同时也由于现有文献有限。当临床症状与压迫部位相关,并且有血流动力学改变的证据,包括静脉高压、侧支/静脉曲张形成和/或血栓形成时,应考虑存在明显的静脉压迫。一般来说,静脉压迫的治疗应针对压迫的病因,而不是仅仅治疗与之相关的症状,如明显的静脉曲张或对血栓进行抗凝治疗,以避免症状复发。