Li Wei, Yin Yu, Gu Chengtao, Fan Baorui, Duan Pengfei, Jin Yonghai, Ni Caifang
Department of Vascular and Interventional Radiology, First Affiliated Hospital of Soochow University, Suzhou, China.
Phlebology. 2020 Aug;35(7):524-532. doi: 10.1177/0268355520904270. Epub 2020 Feb 6.
To evaluate the safety and short-term outcomes of the modified one-session endovascular treatment with inferior vena cava filter placement and retrieval in one stage for the treatment of acute lower extremity deep vein thrombosis.
Twenty-three patients with unilateral acute lower extremity deep vein thrombosis underwent modified one-session endovascular treatments, which were performed in one stage. Inferior vena cava filter placement without detachment, thrombectomy, and inferior vena cava filter retrieval were performed in one stage. Angioplasty and stent implantation were performed for patients with iliac vein stenosis. Venography was performed to identify the clearance of the thrombus. Color Doppler ultrasound and/or venography were conducted during the follow-up.
A total of 20/23 (87%) patients with thrombus removal rate >90% successfully underwent modified one-session endovascular treatment. inferior vena cava filters were detached in 3/23 (13%) patients achieving 50%-90% thrombus removal rate. Twenty-one iliac vein stents were implanted in 21/23 (91%) patients with iliac vein stenosis. After treatment, the differences in the circumferences of the affected limb and the healthy limb both significantly decreased. No procedure-related death, symptomatic pulmonary embolism, or major bleeding occurred. During the 12-25 months of follow-up, iliac vein stents and lower extremity veins maintained patent.
The modified one-session endovascular treatment with one-stage inferior vena cava filter placement and retrieval might be safe for the treatment of acute lower extremity deep vein thrombosis, and the early clinical outcomes are satisfactory. Placing and retrieving an inferior vena cava filter in one session could safeguard the endovascular interventions as well as reduce the filter-related complications associated with long dwelling times.
评估改良一次性血管内治疗一期置入并取出下腔静脉滤器治疗急性下肢深静脉血栓形成的安全性和短期疗效。
23例单侧急性下肢深静脉血栓形成患者接受改良一次性血管内治疗，该治疗在一期完成。一期进行不释放的下腔静脉滤器置入、血栓清除术及下腔静脉滤器取出。对髂静脉狭窄患者行血管成形术和支架植入术。行静脉造影以确定血栓清除情况。随访期间行彩色多普勒超声和/或静脉造影。
23例患者中，20例（87%）血栓清除率>90%，成功接受改良一次性血管内治疗。23例中有3例（13%）血栓清除率为50%-90%的患者下腔静脉滤器被释放。23例中有21例（91%）髂静脉狭窄患者植入了21枚髂静脉支架。治疗后，患侧肢体与健侧肢体周径差异均显著减小。未发生与手术相关的死亡、症状性肺栓塞或大出血。在12-25个月的随访期间，髂静脉支架和下肢静脉保持通畅。
改良一次性血管内治疗一期置入并取出下腔静脉滤器治疗急性下肢深静脉血栓形成可能是安全的，早期临床疗效满意。一次性置入并取出下腔静脉滤器可保障血管内干预，同时减少与滤器长期留置相关的并发症。
