Radiology Department, CHRU, Montpellier, France.
Radiology Department, CHRU, Grenoble, France.
Cardiovasc Intervent Radiol. 2022 Aug;45(8):1165-1172. doi: 10.1007/s00270-022-03179-y. Epub 2022 Jun 14.
Surgical plication of inferior vena cava was commonly used until the 1980s for prevention of pulmonary embolism, associated with high incidence of post-thrombotic syndrome (PTS). This study aims to assess the feasibility and safety of endovascular iliocaval recanalization after intentionally surgically interrupted inferior vena cava by external plicating clip.
Endovascular iliocaval recanalizations in relation to previous vena cava clip plication were extracted from the retrospective French multicentre database and further analysed. All procedure data were retrospectively reviewed, including technical aspects, technical success and outcomes (clinical response and ultrasound stent patency).
From 2016 to 2018, 8 patients from 4 different centres underwent endovascular iliocaval recanalization for PTS in relation to previous caval interruption by clip. Recanalization of iliocaval occlusion through the clip and stent reconstruction were successfully performed for all of them without complications. After angioplasty, plicating clip was opened in U shape (n = 3) or ovalized without significant residual stenosis (n = 5). Patency of the inferior vena cava was maintained for all patients with a mean follow-up of almost two years after stenting. All patients clinically improved.
In this small cases series, endovascular recanalization and stenting of surgical vena cava clip plication seem technically feasible without morbidity. Restoration of blood flow through the iliocaval occlusion, using non-invasive endovascular technique, even as late treatment may be durable, with improvement of patient's venous symptoms.
4, Short Communication.
下腔静脉外科结扎术在 20 世纪 80 年代以前常用于预防肺栓塞，但其与较高的血栓后综合征（PTS）发生率相关。本研究旨在评估在外科结扎夹阻断下腔静脉后，通过血管内髂静脉再通术的可行性和安全性。
从回顾性法国多中心数据库中提取了与既往腔静脉夹结扎相关的血管内髂静脉再通术，并进一步分析。回顾性分析了所有手术数据，包括技术方面、技术成功率和结果（临床反应和超声支架通畅性）。
2016 年至 2018 年，4 家不同中心的 8 例患者因 PTS 而行血管内髂静脉再通术，与既往夹阻断下腔静脉有关。所有患者均成功通过夹和支架重建进行髂静脉闭塞再通，无并发症发生。血管成形术后，夹呈 U 形打开（n=3）或椭圆形，无明显残余狭窄（n=5）。所有患者的下腔静脉通畅性在支架置入后平均近 2 年的随访中得以维持，所有患者的临床症状均有所改善。
在本小系列病例中，血管内再通和支架置入治疗外科结扎夹结扎术在技术上是可行的，且无并发症。使用非侵入性血管内技术恢复髂静脉闭塞的血流，即使是晚期治疗，也可能是持久的，患者的静脉症状会得到改善。
4，短篇通讯。
