Tu L K, Nie M L, Fu J, Liu F Y, Chen Y K, Sun J M, Wang H Y
Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, China.
Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Vascular. 2022 Apr;30(2):341-348. doi: 10.1177/17085381211003776. Epub 2021 Apr 14.
To compare the efficacy of endovascular treatment for iliac vein compression syndrome (IVCS) with or without acute deep venous thrombosis of lower extremity.
This study retrospectively analyzed the clinical data of 300 IVCS patients, who received endovascular treatment between January 2013 and December 2017. According to whether IVCS was complicated by deep venous thrombosis or not, these patients were divided into non-thrombotic iliac vein lesion group (NIVL group, = 127) and post-thrombotic iliac vein lesion group (PIVL group, = 173). After endovascular treatment, all patients were followed up to assess the symptoms improvement and to evaluate the patency of iliac vein.
The technical success rate was 98% (294/300), and percutaneous transluminal angioplasty with stenting was adopted in 294 cases. The incidence of perioperative complications was 36.33% (109/300), but no severe complications occurred. During a mean follow-up of 22.3 months (range 6-30 months), 9(6.82%, 9/132) patients in PIVL group had recurrence of deep venous thrombosis, but nobody had deep venous thrombosis and varicose veins recurrence in NIVL group. The effective rate of endovascular treatment in NIVL group and PIVL group was 96.88% and 90.15% (=0.050), while the cumulative primary patency of iliac vein in NIVL group was significantly higher than that in PIVL group (=0.008).
The endovascular treatment is an effective, feasible, safe method for treating IVCS. There is no difference in the efficacy of IVCS patients with or without deep venous thrombosis, but the medium and long-term patency of patients with deep venous thrombosis is lower than that in patients without deep venous thrombosis.
比较血管腔内治疗髂静脉压迫综合征（IVCS）伴或不伴急性下肢深静脉血栓形成的疗效。
本研究回顾性分析了2013年1月至2017年12月期间接受血管腔内治疗的300例IVCS患者的临床资料。根据IVCS是否合并深静脉血栓形成，将这些患者分为无血栓形成的髂静脉病变组（NIVL组，n = 127）和血栓形成后的髂静脉病变组（PIVL组，n = 173）。血管腔内治疗后，对所有患者进行随访，评估症状改善情况并评价髂静脉通畅情况。
技术成功率为98%（294/300），294例采用经皮腔内血管成形术加支架置入术。围手术期并发症发生率为36.33%（109/300），但未发生严重并发症。在平均22.3个月（范围6 - 30个月）的随访期间，PIVL组有9例（6.82%，9/132）患者深静脉血栓形成复发，但NIVL组无患者深静脉血栓形成和静脉曲张复发。NIVL组和PIVL组血管腔内治疗的有效率分别为96.88%和90.15%（P = 0.050），而NIVL组髂静脉的累积原发性通畅率显著高于PIVL组（P = 0.008）。
血管腔内治疗是治疗IVCS的一种有效、可行、安全的方法。IVCS伴或不伴深静脉血栓形成患者的疗效无差异，但深静脉血栓形成患者的中长期通畅率低于无深静脉血栓形成的患者。
