Chick Jeffrey Forris Beecham, Jo Alexandria, Meadows J Matthew, Abramowitz Steven D, Khaja Minhaj S, Cooper Kyle J, Williams David M
Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109.
Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109.
J Vasc Interv Radiol. 2017 Jul;28(7):933-939. doi: 10.1016/j.jvir.2017.04.017. Epub 2017 May 18.
To report technical success, outcomes, and patency of iliocaval stent reconstruction for inferior vena cava (IVC) filter-bearing iliocaval thrombosis.
A total of 120 patients with 123 IVC filters and symptomatic iliocaval thrombosis underwent stent reconstruction. Mean patient age was 55 years (range, 19-88 y). Filters included 70 (57%) retrievable and 53 (43%) permanent filters. Symptoms included lower extremity swelling or pain (n = 93), ulcers (n = 8), phlegmasia (n = 7), back pain (n = 5), shortness of breath (n = 4), worsening renal function (n = 2), and stenosis identified during translumbar catheter placement (n = 1). Clinical success was defined as decrease in clinical, etiology, anatomy, and pathophysiology (CEAP) score of at least 1; resolution of presenting symptoms; or normalization of renal function in patients with juxtarenal or suprarenal thrombosis on presentation. Technical aspects of reconstruction, technical success, complications, 6-month clinical response, and 6-, 12-, and 24-month primary, primary-assisted, and secondary stent patency rates were recorded.
Stent reconstruction was technically successful in all 120 patients, 63 of whom (53%) underwent thrombolysis. Thirty filters (24%) were retrieved, and 93 (76%) were excluded with stent placement across the indwelling filter. Six minor and 2 major complications occurred. Clinical success was achieved in 115 patients (96%) at 6 months. Six-, 12-, and 24-month primary iliocaval stent patency rates were 96.4%, 94.8%, and 87.2%, respectively. Twenty-four month primary-assisted and secondary patency rates were 90.3% and 94.2%, respectively.
Iliocaval stent reconstruction is an effective treatment for filter-associated thrombosis with 100% technical success and 96% clinical success at 6 months. Technical and clinical outcomes in patients who underwent filter retrieval versus filter exclusion were similar.
报告髂股静脉支架重建术治疗下腔静脉（IVC）滤器相关髂股静脉血栓形成的技术成功率、治疗效果及通畅率。
120例患者共植入123枚IVC滤器，均有症状性髂股静脉血栓形成，接受了支架重建术。患者平均年龄55岁（范围19 - 88岁）。滤器包括70枚（57%）可回收滤器和53枚（43%）永久性滤器。症状包括下肢肿胀或疼痛（n = 93）、溃疡（n = 8）、股白肿（n = 7）、背痛（n = 5）、气短（n = 4）、肾功能恶化（n = 2）以及经腰导管置入时发现的狭窄（n = 1）。临床成功定义为临床、病因、解剖和病理生理（CEAP）评分至少降低1分；出现的症状缓解；或初诊时患有肾周或肾上血栓形成的患者肾功能恢复正常。记录重建的技术细节、技术成功率、并发症、6个月时的临床反应以及6个月、12个月和24个月时的初次、初次辅助和二次支架通畅率。
120例患者的支架重建术技术均成功，其中63例（53%）接受了溶栓治疗。30枚滤器（24%）被取出，93枚（76%）通过在留置滤器上放置支架而被排除。发生了6例轻微并发症和2例严重并发症。6个月时11
