Center for Vascular Medicine, Glen Burnie, USA.
Center for Vein Restoration, Greenbelt, USA.
Phlebology. 2020 Dec;35(10):805-813. doi: 10.1177/0268355520941385. Epub 2020 Jul 14.
In patients receiving stents for symptomatic non-thrombotic iliac vein lesions, many clinicians prescribe anti-thrombotic medications. Whether or not anti-coagulation post-venous stenting improves stent patency is unknown. The aim of this investigation is to determine whether prophylactic post-operative anti-thrombotic therapy improves stent patency and/or prevents in-stent restenosis.
The medical records and venous ultrasounds for 389 patients stented for non-thrombotic iliac vein lesions were retrospectively reviewed. Patients were categorized into three anti-thrombotic regimens: Clopidogrel, Aspirin and Clopidogrel, and Apixaban or Rivaroxaban. Patients were routinely assessed for restenosis and stent patency at 6, 26, and 52 weeks and treated with anti-thrombotics for 90 days.
Freedom from in-stent restenosis at 6, 26, and 52 weeks were Clopidogrel (91.50, 82.91, 80.95%), Aspirin and Clopidogrel (88.68, 80.03, 80.03%), and Apixaban or Rivaroxaban (91.03, 85.11, 83.18%). Primary patencies were Clopidogrel (98.77, 98.77, 98.10%), Aspirin and Clopidogrel (100, 95.74, 95.74%), and Apixaban or Rivaroxaban (98.70, 98.70, 96.71%). There were no statistically significant differences.
The type of post-operative anti-thrombotic therapy for non-thrombotic iliac vein lesions does not appear to improve stent patency or prevent the development of in-stent restenosis.
在因症状性非血栓性髂静脉病变而接受支架治疗的患者中，许多临床医生会开具抗血栓药物。静脉支架置入术后是否抗凝能改善支架通畅性尚不清楚。本研究旨在确定术后预防性抗血栓治疗是否能改善支架通畅性和/或预防支架内再狭窄。
回顾性分析 389 例因非血栓性髂静脉病变行支架置入术患者的病历和静脉超声资料。患者被分为三组抗血栓治疗方案：氯吡格雷、阿司匹林和氯吡格雷、以及阿哌沙班或利伐沙班。患者在术后 6、26 和 52 周时常规接受再狭窄和支架通畅性评估，并接受 90 天的抗血栓治疗。
6、26 和 52 周时无支架内再狭窄的比例分别为氯吡格雷组（91.50%、82.91%、80.95%）、阿司匹林和氯吡格雷组（88.68%、80.03%、80.03%）和阿哌沙班或利伐沙班组（91.03%、85.11%、83.18%）。支架原发性通畅率分别为氯吡格雷组（98.77%、98.77%、98.10%）、阿司匹林和氯吡格雷组（100%、95.74%、95.74%）和阿哌沙班或利伐沙班组（98.70%、98.70%、96.71%）。三组间无统计学差异。
非血栓性髂静脉病变术后抗血栓治疗的类型似乎并不能改善支架通畅性或预防支架内再狭窄的发生。
