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髂股静脉慢性阻塞性病变支架置入的适应证、技术要点及疗效。

Indications, technical aspects, and outcomes of stent placement in chronic iliofemoral venous obstruction.

机构信息

Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.

Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburg, PA.

出版信息

J Vasc Surg Venous Lymphat Disord. 2024 Sep;12(5):101904. doi: 10.1016/j.jvsv.2024.101904. Epub 2024 May 15.

Abstract

BACKGROUND

Iliofemoral venous stent placement (IVS) has evolved to a well-established endovascular treatment modality for chronic iliofemoral venous obstruction (CIVO). Dedicated venous stents gained approval from the US Food and Drug Administration in 2019 and solidified IVS as a defined intervention with clear indications, contraindications, risks, benefits, and procedural management principles. This review focuses on the indications, technical aspects and outcomes of stenting for CIVO. Other aspects pertaining to IVS are covered in other articles that are a part of this series.

METHODS

This study conducted a literature search limited to English articles. Three search strategies were used, and references were managed in Covidence software. Four investigators screened and evaluated articles independently, excluding meta-analyses, clinical trial protocols, and nonrelevant studies. Eligible studies, focused on clinical outcomes and stent patencies, underwent thorough review.

RESULTS

The literature search yielded 1704 studies, with 147 meeting eligibility criteria after screening and evaluation. Exclusions were based on duplicates, irrelevant content, and noniliac vein stent placement.

CONCLUSIONS

Successful IVS for CIVO relies on meticulous patient selection, consistent use of intravascular ultrasound examination during procedures and attention to the technical details of IVS.

摘要

背景

髂股静脉支架置入术(IVS)已发展成为慢性髂股静脉阻塞(CIVO)的一种成熟的血管内治疗方法。专用静脉支架于 2019 年获得美国食品和药物管理局的批准,将 IVS 确定为一种具有明确适应证、禁忌证、风险、益处和操作管理原则的明确干预措施。本综述重点介绍 CIVO 支架置入的适应证、技术方面和结果。与 IVS 相关的其他方面在本系列的其他文章中有所涉及。

方法

本研究仅对英文文章进行了文献检索。使用了三种搜索策略,并在 Covidence 软件中管理参考文献。四名调查员独立筛选和评估文章,排除了荟萃分析、临床试验方案和不相关的研究。对重点关注临床结局和支架通畅性的合格研究进行了全面审查。

结果

文献检索得到了 1704 项研究,经过筛选和评估,有 147 项符合入选标准。排除的原因是重复、内容不相关和非髂静脉支架置入。

结论

成功进行 CIVO 的 IVS 依赖于对患者的精心选择、在手术过程中持续使用血管内超声检查以及对 IVS 技术细节的关注。

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