经血管内治疗下腔静脉漂浮血栓。
Endovascular therapy for floating thrombus in the inferior vena cava.
机构信息
Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
出版信息
J Int Med Res. 2020 Sep;48(9):300060520959990. doi: 10.1177/0300060520959990.
OBJECTIVE
We aimed to summarize the clinical characteristics of floating thrombus in the inferior vena cava (IVC).
METHODS
From January 2014 to June 2019, four patients with floating thrombus in the IVC were admitted to our hospital and underwent intracavitary therapy. Diagnosis, therapy, and clinical characteristics of floating thrombus were summarized.
RESULTS
Three patients presented with pulmonary embolism. Three of the patients had a floating thrombus discovered by inferior venacavography and one was found by contrast-enhanced computed tomography. Two patients had deep venous thrombosis in the lower extremities. One patient had a double IVC, one had left iliac vein compression syndrome, and one had right renal phlebothrombosis. The four patients underwent implantation of a temporary IVC filter and were treated with anti-coagulation, debulking, and thrombolysis. All four patients achieved satisfactory results.
CONCLUSIONS
Floating thrombus in the IVC is often caused by spread of branch vein thrombosis, and is more likely to lead to pulmonary embolism. Anti-coagulant therapy and debulking under the protection of filters can achieve satisfactory clinical results.
目的
总结下腔静脉（IVC）内漂浮血栓的临床特征。
方法
2014 年 1 月至 2019 年 6 月，我院收治 4 例 IVC 内漂浮血栓患者，均行腔内治疗。总结漂浮血栓的诊断、治疗及临床特征。
结果
3 例患者表现为肺栓塞。3 例经下腔静脉造影发现漂浮血栓，1 例经增强 CT 发现。2 例患者下肢深静脉血栓形成。1 例患者存在双下腔静脉，1 例存在左侧髂静脉压迫综合征，1 例存在右肾静脉血栓形成。4 例患者均植入临时下腔静脉滤器，并进行抗凝、溶栓、取栓治疗。4 例患者均获得满意疗效。
结论
IVC 内漂浮血栓多由分支静脉血栓蔓延所致，更易导致肺栓塞。在滤器保护下抗凝溶栓治疗可获得满意的临床效果。
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