Ozawa Mizuki, Sone Miyuki, Sugawara Shunsuke, Itou Chihiro, Kimura Shintaro, Arai Yasuaki, Kusumoto Masahiko
Department of Diagnostic Radiology, National Cancer Center Hospital, Japan.
Interv Radiol (Higashimatsuyama). 2023 Jul 1;8(2):70-74. doi: 10.22575/interventionalradiology.2022-0028.
Although percutaneous stent placement for malignant inferior vena cava syndrome is a highly feasible and effective treatment option, there is no clear evidence for the necessity of prophylactic anticoagulation therapy after inferior vena cava stent placement. This study retrospectively evaluated the necessity of prophylactic anticoagulation following inferior vena cava stent placement in patients with malignant inferior vena cava syndrome.
The data of 54 patients (28 men and 26 women; median age 61.2 years) with malignant inferior vena cava syndrome who received inferior vena cava stent placement between 2011 and 2021 were retrospectively reviewed. Prophylactic anticoagulation was administered to 15 of 54 patients (27.8%) following stent placement. Symptom recurrence rates at 1 and 2 months after stent placement were compared between patients with and without prophylactic anticoagulation using Gray relational analysis. The timeline of symptom recurrence, survival time, and adverse events were also evaluated.
At 1 and 2 months, symptom recurrence rates were 48.6% and 71.4%, respectively, in patients with prophylactic anticoagulation and 28.3% and 37.0%, respectively, in patients without prophylactic anticoagulation. The overall median follow-up duration was 27 days and that of the patients with and without prophylactic anticoagulation was 37 and 25 days, respectively. The median survival times of patients with and without anticoagulation therapy were 69 and 30 days, respectively (p = 0.236). No procedure-related complications occurred.
There was no significant difference in the symptom recurrence rates after inferior vena cava stent placement with or without prophylactic anticoagulation in this study.
尽管经皮置入支架治疗恶性下腔静脉综合征是一种高度可行且有效的治疗选择，但尚无明确证据表明下腔静脉支架置入术后预防性抗凝治疗的必要性。本研究回顾性评估了恶性下腔静脉综合征患者下腔静脉支架置入术后预防性抗凝的必要性。
回顾性分析2011年至2021年间接受下腔静脉支架置入术的54例恶性下腔静脉综合征患者（28例男性和26例女性；中位年龄61.2岁）的数据。54例患者中有15例（27.8%）在支架置入后接受了预防性抗凝治疗。采用灰色关联分析比较了接受和未接受预防性抗凝治疗的患者在支架置入后1个月和2个月时的症状复发率。还评估了症状复发的时间线、生存时间和不良事件。
在1个月和2个月时，接受预防性抗凝治疗的患者症状复发率分别为48.6%和71.4%，未接受预防性抗凝治疗的患者分别为28.3%和37.0%。总体中位随访时间为27天，接受和未接受预防性抗凝治疗的患者分别为37天和25天。接受和未接受抗凝治疗的患者中位生存时间分别为69天和3天（p = 0.236）。未发生与手术相关的并发症。
本研究中，下腔静脉支架置入术后无论是否进行预防性抗凝，症状复发率均无显著差异。
