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急性下肢症状不可忽视的病因——3例合并深静脉血栓形成的梅-图二氏综合征

Nonnegligible causes of symptoms of acute lower extremities--3 cases of May-Thurner syndrome with deep vein thrombosis.

作者信息

Sun Yi, Song Shenghan

机构信息

Department of Vascular Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.

出版信息

Thromb J. 2021 Apr 19;19(1):25. doi: 10.1186/s12959-021-00278-7.

Abstract

BACKGROUND

May-Thurner syndrome is a kind of disease caused by the compression of the left common iliac vein. It is one of the causes of incomplete venous valves and superficial varicose veins in lower limbs, and is also a potential factor of acute deep vein thrombosis (DVT).

METHOD

Here 3 cases are diagnosed as May-Thurner syndrome at different ages.

CASE PRESENTATIONS

  1. A 35-year-old female patient was hospitalized with swelling of the left lower limb for 1 week. Computed tomography (CT) showed compression of the left common iliac vein with thrombosis. May-Thurner syndrome was diagnosed and catheter-directed thrombolysis was performed. 2. A 37-year-old male patient came to our hospital due to sudden swelling of the right lower extremity and pain for 3 days. Computed tomography showed compression of the left common iliac vein and deep venous thrombosis (DVT) of the right iliac vein. May-Thurner syndrome was diagnosed. The patient was performed with inferior vena cava (IVC) filter implantation, catheter-directed thrombolysis and balloon angioplasty for right iliac vein. And the patient recovered well; 3. A 55-year-old female patient came to our hospital with swelling and discomfort in the left lower extremity for 3 days. Computed tomography showed stenosis of the left common iliac vein with deep vein thrombosis. May-Thurner syndrome was diagnosed, balloon dilation and stent implantation were performed. During 3 years of follow-up, there was no swelling or new thrombosis in her lower limbs.

CONCLUSION

When encountering unexplained deep vein thrombosis, iliac vein compression syndrome should be considered and treated in time to prevent the recurrence of thrombosis. Catheter-directed thrombolysis can relieve symptoms and stenting placement is the optimal way to relieve stenosis, supplemented by long-term anticoagulation therapy and graduated compression stockings.

摘要

背景

梅-图二氏综合征是一种由左髂总静脉受压引起的疾病。它是下肢静脉瓣膜不全和浅静脉曲张的病因之一,也是急性深静脉血栓形成(DVT)的潜在因素。

方法

本文报道3例不同年龄段诊断为梅-图二氏综合征的病例。

病例介绍

  1. 一名35岁女性患者因左下肢肿胀1周入院。计算机断层扫描(CT)显示左髂总静脉受压并伴有血栓形成。诊断为梅-图二氏综合征并进行了导管定向溶栓治疗。2. 一名37岁男性患者因右下肢突然肿胀和疼痛3天前来我院就诊。CT显示左髂总静脉受压及右髂静脉深静脉血栓形成(DVT)。诊断为梅-图二氏综合征。该患者接受了下腔静脉(IVC)滤器植入、导管定向溶栓及右髂静脉球囊血管成形术治疗,恢复良好;3. 一名55岁女性患者因左下肢肿胀不适3天前来我院就诊。CT显示左髂总静脉狭窄并伴有深静脉血栓形成。诊断为梅-图二氏综合征,进行了球囊扩张及支架植入术。随访3年期间,其下肢无肿胀或新的血栓形成。

结论

遇到不明原因的深静脉血栓形成时,应考虑髂静脉压迫综合征并及时治疗,以预防血栓复发。导管定向溶栓可缓解症状,支架置入是缓解狭窄的最佳方法,辅以长期抗凝治疗和分级压力袜。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69dc/8054378/f31edfdce83d/12959_2021_278_Fig1_HTML.jpg

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