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[慢性静脉流出道梗阻的血管内再通术]

[Endovascular Recanalization of Chronic Venous Outflow Obstructions].

作者信息

Lichtenberg Michael K W

机构信息

Klinik für Angiologie, Klinikum Hochsauerland GmbH, Arnsberg.

出版信息

Dtsch Med Wochenschr. 2019 Apr;144(7):478-483. doi: 10.1055/a-0653-7714. Epub 2019 Mar 29.

Abstract

Approximately 60 % of patients with acute iliofemoral deep vein thrombosis recover without further symptoms. However, 40 % will have some degree of post-thrombotic syndrome (PTS) and 4 % will develop severe PTS. PTS is the most common complication; it reduces quality of life and increases DVT-related costs. The clinical symptoms and severity of PTS may vary; the most common symptoms include edema, pain, hyperpigmentation, lipodermatosclerosis, and ulceration. PTS is based on the principle of outflow obstruction, may be caused by venous hypertension, and may lead to valvular damage and venous reflux or insufficiency. A significant lumen reduction within the iliac vein system is defined by an aspect ratio ≥ 2. Recent technical developments and new dedicated venous stent techniques now give the opportunity to recanalize even complex venous outflow obstructions. First in man safety and efficacy data are very promising for the new dedicated venous stents, but long-term data are still missing.

摘要

大约60%的急性髂股深静脉血栓形成患者可康复且无进一步症状。然而,40%的患者会出现一定程度的血栓后综合征(PTS),4%的患者会发展为严重的PTS。PTS是最常见的并发症,它会降低生活质量并增加与深静脉血栓形成相关的费用。PTS的临床症状和严重程度可能各不相同,最常见的症状包括水肿、疼痛、色素沉着、脂性皮肤硬化和溃疡。PTS基于流出道梗阻的原理,可能由静脉高压引起,并可能导致瓣膜损伤和静脉反流或功能不全。髂静脉系统内管腔显著缩小定义为纵横比≥2。最近的技术发展和新的专用静脉支架技术现在为甚至复杂的静脉流出道梗阻再通提供了机会。新型专用静脉支架的人体首次安全性和有效性数据非常有前景,但长期数据仍然缺乏。

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