Harrison Brittany, Hao Frank, Koney Nii, McWilliams Justin, Moriarty John M
Department of Interventional Radiology, University of California, Los Angeles, CA.
Department of Interventional Radiology, University of California, Los Angeles, CA.
Tech Vasc Interv Radiol. 2018 Jun;21(2):65-77. doi: 10.1053/j.tvir.2018.03.002. Epub 2018 Mar 9.
Thromboses of the superior and inferior vena cava, either isolated or associated with distal deep venous thrombosis, are uncommon, but confer potentially serious morbidity and mortality. Incidence is increasing, especially with the prominence of intravascular devices. The range of treatment options is also expanding to include medical management, surgery, and endovascular techniques which are now frequently considered first line therapy due to lower reintervention rates and decreased periprocedural morbidity. Currently, there are no official guidelines for screening or treatment. This article reviews the etiology, diagnosis, and management of caval thromboses, including equipment, procedural steps, outcomes, and complications, particularly with regard to endovascular techniques, such as catheter-directed thrombolysis, pharmacomechanical catheter-directed thrombolysis, angioplasty, and stenting.
上腔静脉和下腔静脉血栓形成，无论是孤立性的还是与远端深静脉血栓形成相关的，都不常见，但具有潜在的严重发病率和死亡率。其发病率正在上升，尤其是随着血管内装置的普及。治疗选择的范围也在扩大，包括药物治疗、手术和血管内技术，由于再干预率较低和围手术期发病率降低，血管内技术现在经常被视为一线治疗方法。目前，尚无关于筛查或治疗的官方指南。本文综述了腔静脉血栓形成的病因、诊断和管理，包括设备、操作步骤、结果和并发症，特别是关于血管内技术，如导管定向溶栓、药物机械导管定向溶栓、血管成形术和支架置入术。
