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下肢静脉曲张复发的手术治疗与髂静脉狭窄的血管内治疗相关。

Surgical treatment of recurrent varicose veins in the lower limbs associated with endovascular treatment of iliac vein stenosis.

机构信息

Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China, Graduate School of Peking Union Medical College, Beijing, 100029, China.

Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China, Graduate School of Peking Union Medical College, Beijing, 100029, China.

出版信息

Int J Surg. 2018 Feb;50:110-113. doi: 10.1016/j.ijsu.2018.01.004. Epub 2018 Jan 12.

DOI:10.1016/j.ijsu.2018.01.004
PMID:29337179
Abstract

OBJECTIVE

We present our experience with endovascular surgery for recurrent varicose veins (RVV) of the lower limbs combined with the iliac vein compression syndrome (IVCS).

MATERIALS AND METHODS

This study was a retrospective analysis of 6 patients with RVVs combined with IVCS who were admitted to our hospital between January 2007 and December 2014. Transfemoral venography was performed to confirm IVCS. Balloon dilation and stent placement were successful in all 6 patients. The varicose veins were treated by traditional surgery after the endovascular therapy. The visual analog pain scale (VAS) score and venous clinical severity score (VCSS) were collected before surgery and at 6-months follow-up, and were analyzed using the paired student t-test. Patency of the iliac vein was assessed via duplex Doppler ultrasound.

RESULTS

The rate of technical success was 100%. There was a significant (p < .001) improvement in VCSS postoperatively. During the 6-month follow-up period, no RVVs were observed and the rate of iliac vein patency was 100%. Importantly, VAS ratings also decreased significantly (p < .001) during the follow-up.

CONCLUSION

Endovascular surgery for IVCS combined with traditional surgery focused on varicose veins is an effective procedure for treating RVVs of the lower limbs associated with IVCS within 6 months.

摘要

目的

我们介绍下肢复发性静脉曲张(RVV)合并髂静脉压迫综合征(IVCS)的血管内手术治疗经验。

材料和方法

本研究回顾性分析了 2007 年 1 月至 2014 年 12 月期间我院收治的 6 例 RVV 合并 IVCS 患者。经股静脉造影证实 IVCS。所有 6 例患者均成功进行了球囊扩张和支架置入。血管内治疗后,采用传统手术治疗静脉曲张。收集患者术前和术后 6 个月的视觉模拟疼痛评分(VAS)和静脉临床严重程度评分(VCSS),采用配对学生 t 检验进行分析。采用双功能多普勒超声评估髂静脉通畅情况。

结果

技术成功率为 100%。术后 VCSS 显著改善(p<0.001)。在 6 个月的随访期间,未观察到 RVV,髂静脉通畅率为 100%。重要的是,随访期间 VAS 评分也显著降低(p<0.001)。

结论

血管内手术治疗 IVCS 合并传统手术治疗侧重于静脉的静脉曲张,是治疗 6 个月内下肢 RVV 合并 IVCS 的有效方法。

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