Han Yang, Tian Ye, Gao Lu, Tang Jingdong, Fan Pengcheng, Cong Longlong, Dong Jian, Yang Lin
Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Int J Surg. 2022 May;101:106641. doi: 10.1016/j.ijsu.2022.106641. Epub 2022 Apr 29.
This study aimed to investigate the short-term outcomes of three endovenous procedures in patients with varicose veins (VVs) and severe iliac vein compression syndrome (IVCS).
A total of 158 consecutive patients were included in this multicenter retrospective study from May 2017 to December 2019; 54 patients underwent endovenous laser ablation (EVLA) alone, 47 patients underwent EVLA and balloon angioplasty (BA), and 57 patients underwent EVLA and stenting angioplasty (SA). Clinical outcomes and complications were assessed at one and twelve months post-surgery. The Quality of life (QoL) was assessed by the venous clinical severity score (VCSS) and Aberdeen Varicose Vein Questionnaire (AVVQ).
Patients who underwent the SA procedure were older (P < 0.05). Incidence of laser ablation complications was similar among the three procedures; closure rates of the great saphenous vein were 96.8%, 98.0%, and 98.4%, respectively, at 12 months. Reflux times in the SA procedure were lower than those in the EVLA and BA procedures at 12 months, while ulcer healing time was faster with the SA procedure (P < 0.05) than with the other procedures. The VCSS and AVVQ values were significantly improved post-procedure (P < 0.05), with lower AVVQ scores in the SA procedure than in the EVLA and BA procedures at 12 months post-surgery. The EVLA and BA procedures (stenosis >70%) caused a significantly higher symptom recurrence than the SA procedure, with an odds ratios of 14.04 (95% confidence interval (CI), 1.99-99.18) and 10.50 (95% CI, 1.26-87.15), respectively.
Our results demonstrate that EVLA and SA procedures relieve symptoms, improve the QoL, and decrease symptom recurrence in patients with VVs and severe IVCS (stenosis >70%).
本研究旨在调查三种静脉内治疗方法对静脉曲张（VVs）合并严重髂静脉受压综合征（IVCS）患者的短期疗效。
本多中心回顾性研究纳入了2017年5月至2019年12月期间连续的158例患者；54例患者仅接受了静脉腔内激光消融术（EVLA），47例患者接受了EVLA联合球囊血管成形术（BA），57例患者接受了EVLA联合支架血管成形术（SA）。在术后1个月和12个月评估临床疗效和并发症。采用静脉临床严重程度评分（VCSS）和阿伯丁静脉曲张问卷（AVVQ）评估生活质量（QoL）。
接受SA治疗的患者年龄较大（P<0.05）。三种治疗方法中激光消融并发症的发生率相似；大隐静脉在12个月时的闭合率分别为96.8%、98.0%和98.4%。SA治疗在12个月时的反流时间低于EVLA和BA治疗，而SA治疗的溃疡愈合时间比其他治疗方法更快（P<0.05）。术后VCSS和AVVQ值显著改善（P<0.05），SA治疗在术后12个月时的AVVQ评分低于EVLA和BA治疗。EVLA和BA治疗（狭窄>70%）导致的症状复发显著高于SA治疗，优势比分别为14.04（95%置信区间（CI），1.99-99.18）和10.50（95%CI，1.26-87.15）。
我们的结果表明，EVLA和SA治疗可缓解症状，改善生活质量，并降低VVs合并严重IVCS（狭窄>70%）患者的症状复发率。
