Moini Majid, Zafarghandi Mohammad Reza, Taghavi Morteza, Salimi Javad, Tadayon Borna, Mohammad Sadat Sayed Ali, Farshidmehr Pezhman, Noaparast Morteza
Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Science, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Minim Invasive Ther Allied Technol. 2020 Feb;29(1):35-41. doi: 10.1080/13645706.2019.1580748. Epub 2019 Feb 22.
Venous outflow obstruction is a common condition among patients with chronic venous insufficiency. Endovascular treatment is favourable over open surgery. This study aimed to assess stent patency and clinical outcome in venous outflow obstruction of lower limbs, and also to compare it between post-thrombotic syndrome and non-thrombotic iliac vein lesions. The study was a historical cohort study. Patients with chronic deep venous insufficiency referred to our tertiary referral centre who underwent venoplasty were recruited. Patients were divided into two groups: non-thrombotic-iliac-vein-lesions and post-thrombotic syndrome. Stent patency rate, clinical improvement and risk factors were evaluated during a six-months course after venoplasty. One-hundred-sixty-four patients were included. Six-months primary, assisted primary and secondary patency rates were 98.86%, 100% and100% in the non-thrombotic-iliac-vein-lesions group and 88%, 93% and 96% in the post thrombotic syndrome groups (-value = .005, -value = .02, and -value = .09, respectively). Pain, claudication and edema were the most common symptoms in both groups and significantly improved after six months. Early thrombosis in the PTS group was more common (9 vs. 1, value = .007). Percutaneous stenting in patients with venous outflow obstruction is safe and effective with a high patency rate and significant decrease in clinical score in both post-thrombotic syndrome and non-thrombotic-iliac-vein lesions groups.
静脉流出道梗阻是慢性静脉功能不全患者中的常见病症。血管腔内治疗优于开放手术。本研究旨在评估下肢静脉流出道梗阻患者的支架通畅率和临床结局,并比较血栓形成后综合征和非血栓性髂静脉病变患者之间的情况。该研究为历史性队列研究。招募了转诊至我们三级转诊中心并接受静脉成形术的慢性深静脉功能不全患者。患者分为两组:非血栓性髂静脉病变组和血栓形成后综合征组。在静脉成形术后的六个月疗程中评估支架通畅率、临床改善情况和危险因素。共纳入164例患者。非血栓性髂静脉病变组的六个月主要通畅率、辅助主要通畅率和次要通畅率分别为98.86%、100%和100%,血栓形成后综合征组分别为88%、93%和96%(P值分别为0.005、0.02和0.09)。疼痛、间歇性跛行和水肿是两组最常见的症状,六个月后均有显著改善。血栓形成后综合征组早期血栓形成更为常见(9例 vs. 1例,P值 = 0.007)。对于静脉流出道梗阻患者,经皮支架置入术安全有效,在血栓形成后综合征组和非血栓性髂静脉病变组中均具有较高的通畅率且临床评分显著降低。