Feng Qichen, Gai Shuo, Wang Changming, Li Xuan
Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2024 Apr 18;56(2):322-325. doi: 10.19723/j.issn.1671-167X.2024.02.019.
To explore the feasibility and recent efficacy of iliac vein molding and stenting in daytime treatment mode in patients with iliac vein stenosis.
Medical records of iliac vein molding and stenting performed in the ipsilateral great saphenous vein approach conducted from February 2017 to March 2022 were retrospective reviewed. There were 21 cases, 6 males and 15 females. Age ranged from 37 to 79 years [(62.5 ± 10.2) years]. The stenosis in the 21 limbs simply involved the common iliac veins in 16 patients, 2 patients had the simple and external iliac veins, and both the total and external iliac veins in 3 patients. Both iliac vein molding and iliac vein stenting were performed through the ipsilateral great saphenous vein approach. The patients with simple iliac vein stenosis with great saphenous vein valve insufficiency also underwent radiofrequency closure of great saphenous vein and flexural vein sclerosis therapy simultaneously. Regular postoperative direct oral anticoagulants therapy and stress therapy were followed. All the patients were hospitalized for less than 24 h.
All the 21 patients operations were successful (the success rate was 100%), without any intraoperative complications. Immediate postoperative complications were puncture point bleeding in 1 case. The bandage gauze was completely wet. The bleeding was stopped after 5min of recompression. All the patients were hospitalized for less than 24 h. Follow-up results: The 3-month follow-up rate after operation was 100%. Absolute effective 18 cases (18/21, 85.7%). Relatively effective(postmentation still after surgery, but with less extent) in 3 cases (3/21, 14.3%). The iliac vein stents were unobstructed, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment. The 6-month follow-up rate after operation was 71.4%(15/21). Of these, 14 cases (14/15, 93.3%) were absolutely effective. Relatively effective(postmentation still after surgery, but with less extent) in 1 case (1/15, 6.7%). The iliac vein stents were no restenosis or obstruction, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment.
The interventional treatment technique of iliac vein stenosis is feasible in the daytime treatment mode, with clear advantages and satisfactory recent efficacy.
探讨日间治疗模式下行髂静脉成型及支架置入术治疗髂静脉狭窄患者的可行性及近期疗效。
回顾性分析2017年2月至2022年3月采用同侧大隐静脉入路行髂静脉成型及支架置入术的病历资料。共21例患者，男6例，女15例。年龄37～79岁[（62.5±10.2）岁]。21条肢体中，单纯髂总静脉狭窄16例，单纯髂外静脉狭窄2例，髂总静脉及髂外静脉均狭窄3例。均采用同侧大隐静脉入路行髂静脉成型及支架置入术。单纯髂静脉狭窄合并大隐静脉瓣膜功能不全者同时行大隐静脉射频闭合及曲张静脉硬化治疗。术后规律服用直接口服抗凝剂并进行压力治疗。所有患者住院时间均少于24小时。
21例患者手术均成功（成功率100%），术中无并发症。术后即刻并发症1例为穿刺点出血，绷带纱布完全浸湿，再次压迫5分钟后出血停止。所有患者住院时间均少于24小时。随访结果：术后3个月随访率100%。绝对有效18例（18/21，85.7%）。相对有效（术后仍有病变，但程度较轻）3例（3/21，14.3%）。髂静脉支架通畅，大隐静脉射频治疗患者大隐静脉主干闭合良好。术后6个月随访率71.4%（15/21）。其中，绝对有效14例（14/15，93.3%）。相对有效（术后仍有病变，但程度较轻）1例（1/15，6.7%）。髂静脉支架无再狭窄或阻塞，大隐静脉射频治疗患者大隐静脉主干闭合良好。
髂静脉狭窄介入治疗技术在日间治疗模式下可行，优势明显，近期疗效满意。
