Lee Mary M, Hines George L
From the Division of Vascular Surgery, NYU Langone Long Island Hospital and School of Medicine, Mineola, NY.
Cardiol Rev. 2022;30(6):314-317. doi: 10.1097/CRD.0000000000000423. Epub 2021 Oct 18.
Occlusive disease of the iliac veins or major intrathoracic veins have traditionally been managed by conservative management or by major vascular reconstructive procedures. Over the past 15-20 years, these lesions have become amenable to management with venous stents. Lesions in the iliac venous system are typically due to thrombus secondary to deep vein thrombosis, and lesions in the superior vena cava are due to either malignant intrathoracic lesions, indwelling central venous catheters, pacemaker leads, or enlarged nodes due to granulomatous disease. The success rate for implantation is between 92% and 95% and associated implantation complications vary between 2% and 5%. Primary patency of iliac stents is 70-90% at three years. Venous stents have higher patency in the treatment of stenotic lesions compared to totally occlusive lesions. Primary patency of stents placed in the superior vena cava is also about 70-90% and generally lower in lesions due to malignancy likely related to life expectancy. Stents in the venous system are associated with few complications at the time of insertion and have excellent long-term patency.
传统上，髂静脉或胸内主要静脉的闭塞性疾病采用保守治疗或大型血管重建手术进行处理。在过去15至20年中，这些病变已适合采用静脉支架进行治疗。髂静脉系统的病变通常是由深静脉血栓形成继发的血栓引起的，而上腔静脉的病变则是由胸内恶性病变、留置中心静脉导管、起搏器导线或肉芽肿病导致的淋巴结肿大引起的。植入成功率在92%至95%之间，相关植入并发症在2%至5%之间。髂静脉支架三年时的原发性通畅率为70%至90%。与完全闭塞性病变相比，静脉支架在治疗狭窄性病变方面具有更高的通畅率。置于上腔静脉的支架原发性通畅率也约为70%至90%，并且在因恶性肿瘤导致的病变中通常较低，这可能与预期寿命有关。静脉系统中的支架在插入时并发症较少，并且具有出色的长期通畅率。
