John Philip R
Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.
Tech Vasc Interv Radiol. 2019 Dec;22(4):100634. doi: 10.1016/j.tvir.2019.100634. Epub 2019 Sep 23.
Klippel-Trenaunay syndrome or KTS is a complex vascular syndrome associated with overgrowth occurring as a result of somatic mutations in the PIK3CA gene. Patients are diagnosed on the basis of physical findings, sometimes with supportive imaging, of commonly a segmental anomaly with a cutaneous port-wine stain, lymphatic and venous malformations and overgrowth. The severity of the component vascular malformations and the degree of overgrowth varies from patient to patient which demands care given by a multi-professional team with regular follow-up in a specialist clinic. Some patients may present with acute life-threatening problems, often as a result of veno-thromboembolic events (VTEs) especially following surgical and invasive radiological procedures. Awareness of such problems is vital and prophylactic measures to reduce such risks are paramount. The interventional radiologist is vital to the care team as he/she can undertake procedures including endovascular closure of significant venous anomalies which predispose to such VTEs. Although these procedures can be lengthy and complex, they can now provide a minimally invasive means to reduce the risk from life-threatening and sometimes fatal VTEs. The results however from such interventions will require long-term studies which to date are unavailable.
克-特综合征(Klippel-Trenaunay syndrome,KTS)是一种复杂的血管综合征,与PIK3CA基因的体细胞突变导致的过度生长有关。患者根据体格检查结果进行诊断,有时需要影像学检查辅助,通常表现为节段性异常,伴有皮肤葡萄酒色斑、淋巴管和静脉畸形以及过度生长。不同患者的血管畸形严重程度和过度生长程度各不相同,这需要多专业团队在专科诊所进行定期随访并提供护理。一些患者可能会出现危及生命的急性问题,通常是静脉血栓栓塞事件(VTE)的结果,尤其是在手术和侵入性放射学检查之后。认识到这些问题至关重要,降低此类风险的预防措施至关重要。介入放射科医生对护理团队至关重要,因为他/她可以进行包括对易引发此类VTE的重大静脉异常进行血管内封堵等操作。尽管这些操作可能冗长且复杂,但现在它们可以提供一种微创方法来降低危及生命甚至有时致命的VTE风险。然而,此类干预的结果需要长期研究,而目前尚无相关研究。