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右髂外静脉“三明治”的诊断与处理:髂股深静脉血栓形成的罕见原因

Diagnosis and management of right external iliac vein "sandwich": A rare cause of iliofemoral deep venous thrombosis.

作者信息

Tai Elizabeth, Jaberi Arash, Oreopoulos George D, Forbes Thomas L, Tan Kong Teng, Mafeld Sebastian

机构信息

Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Vasc Surg Cases Innov Tech. 2019 Jun 29;5(3):314-318. doi: 10.1016/j.jvscit.2019.02.006. eCollection 2019 Sep.

DOI:10.1016/j.jvscit.2019.02.006
PMID:31334408
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6614602/
Abstract

Several anatomic abnormalities predispose patients to iliofemoral deep venous thrombosis, the most common of which is compression of the left iliac vein between the right common iliac artery and lumbar vertebrae, or May-Thurner syndrome. Other areas of venous compression can occur but are rare. This case report describes the presentation, diagnosis, and management of a patient with compression of the right iliac vein "sandwiched" between the right internal and external iliac arteries. After treatment, the patient demonstrated significant improvement in symptoms.

摘要

几种解剖学异常使患者易患髂股深静脉血栓形成,其中最常见的是左髂静脉在右髂总动脉和腰椎之间受到压迫,即梅-图二氏综合征。其他静脉受压部位也可能发生,但较为罕见。本病例报告描述了一名右髂静脉被右髂内动脉和髂外动脉“夹在中间”受压患者的临床表现、诊断和治疗情况。治疗后,患者症状有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/cd3d42d51975/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/4f932eb0b89b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/a1da952164e3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/b1dd1212428a/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/cd3d42d51975/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/4f932eb0b89b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/a1da952164e3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/b1dd1212428a/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed93/6614602/cd3d42d51975/gr4.jpg

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本文引用的文献

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Endovascular Thrombus Removal for Acute Iliofemoral Deep Vein Thrombosis.急性髂股静脉血栓形成的血管内血栓切除术。
Circulation. 2019 Feb 26;139(9):1162-1173. doi: 10.1161/CIRCULATIONAHA.118.037425.
2
Meta-analysis and systematic review of percutaneous mechanical thrombectomy for lower extremity deep vein thrombosis.经皮机械血栓切除术治疗下肢深静脉血栓形成的荟萃分析和系统评价。
J Vasc Surg Venous Lymphat Disord. 2018 Nov;6(6):788-800. doi: 10.1016/j.jvsv.2018.08.002.
3
Variant May-Thurner syndrome: Compression of the left common iliac vein by the ipsilateral internal iliac artery.
变异型May-Thurner综合征:同侧髂内动脉压迫左髂总静脉。
Radiol Case Rep. 2018 Feb 20;13(2):419-423. doi: 10.1016/j.radcr.2018.01.001. eCollection 2018 Apr.
4
Patency rates and clinical outcomes in a cohort of 200 patients treated with a dedicated venous stent.在接受专用静脉支架治疗的 200 名患者队列中,通畅率和临床结果。
J Vasc Surg Venous Lymphat Disord. 2018 May;6(3):321-329. doi: 10.1016/j.jvsv.2017.09.013. Epub 2018 Feb 13.
5
Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis.药物机械性导管定向溶栓治疗深静脉血栓形成
N Engl J Med. 2017 Dec 7;377(23):2240-2252. doi: 10.1056/NEJMoa1615066.
6
Analysis of threshold stenosis by multiplanar venogram and intravascular ultrasound examination for predicting clinical improvement after iliofemoral vein stenting in the VIDIO trial.分析多平面静脉造影和血管内超声检查的狭窄阈值,以预测 VIDIO 试验中髂股静脉支架置入后临床改善的情况。
J Vasc Surg Venous Lymphat Disord. 2018 Jan;6(1):48-56.e1. doi: 10.1016/j.jvsv.2017.07.009. Epub 2017 Oct 13.
7
Venography versus intravascular ultrasound for diagnosing and treating iliofemoral vein obstruction.静脉造影术与血管内超声在诊断和治疗髂股静脉阻塞中的比较。
J Vasc Surg Venous Lymphat Disord. 2017 Sep;5(5):678-687. doi: 10.1016/j.jvsv.2017.04.007. Epub 2017 Jun 28.
8
Venous Compression Syndromes.静脉压迫综合征
Vasc Endovascular Surg. 2017 Apr;51(3):155-168. doi: 10.1177/1538574417697208.
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Imaging of venous compression syndromes.静脉压迫综合征的影像学检查
Cardiovasc Diagn Ther. 2016 Dec;6(6):519-532. doi: 10.21037/cdt.2016.11.19.
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