Bhave Kieran, Hegde Kausthubh, Kalva Sanjeeva P, Sutphin Patrick D
Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Clin Imaging. 2025 Sep;125:110560. doi: 10.1016/j.clinimag.2025.110560. Epub 2025 Jul 5.
To evaluate the safety and efficacy of percutaneous transluminal angioplasty (PTA) performed within 90 days to treat residual venous stenosis following surgical decompression for venous thoracic outlet syndrome (vTOS).
In this institutional review board (IRB)-approved retrospective study, patients who underwent percutaneous transluminal angioplasty within 90 days of surgical decompression for venous thoracic outlet syndrome between January 2000 and December 2023 were included. Following surgery, patients underwent post-operative venography within 90 days, and percutaneous transluminal angioplasty was performed if there was radiographic evidence of subclavian venous stenosis. Post-angioplasty, patients were followed clinically, and venography was performed if symptoms recurred.
We found 133 patients (mean age = 31.7 years, 54 males) who underwent percutaneous transluminal angioplasty within 90 days of surgical decompression for venous thoracic outlet syndrome. Two patients in our study had bilateral symptoms and underwent bilateral surgical decompression followed by bilateral angioplasty. Percutaneous transluminal angioplasty was technically successful in 127/135 (94.1 %) extremities. In eight (5.9 %) extremities, the venous occlusion could not be crossed. There were no adverse events from the percutaneous angioplasty procedure. Twenty (15.7 %) extremities developed recurrent symptoms at a median of 162 days following percutaneous angioplasty, and venography confirmed the recurrent venous stenosis. The primary patency rates following percutaneous transluminal angioplasty at 6, 12, 36, 60, and 84 months were 92 %, 86 %, 85 %, 84 %, and 83 % respectively.
Residual venous stenosis following surgical decompression for venous thoracic outlet syndrome can be safely and effectively treated with percutaneous transluminal angioplasty within 90 days to achieve high long-term patency rates.
评估在90天内进行经皮腔内血管成形术（PTA）治疗静脉型胸廓出口综合征（vTOS）手术减压后残余静脉狭窄的安全性和有效性。
在这项经机构审查委员会（IRB）批准的回顾性研究中，纳入了2000年1月至2023年12月期间在静脉型胸廓出口综合征手术减压后90天内接受经皮腔内血管成形术的患者。手术后，患者在90天内接受术后静脉造影，如果有锁骨下静脉狭窄的影像学证据，则进行经皮腔内血管成形术。血管成形术后，对患者进行临床随访，如果症状复发则进行静脉造影。
我们发现133例患者（平均年龄=31.7岁，54例男性）在静脉型胸廓出口综合征手术减压后90天内接受了经皮腔内血管成形术。我们研究中的2例患者有双侧症状，接受了双侧手术减压，随后进行了双侧血管成形术。经皮腔内血管成形术在127/135（94.1%）个肢体上技术成功。在8个（5.9%）肢体中，静脉闭塞无法穿过。经皮血管成形术过程中没有不良事件。20个（15.7%）肢体在经皮血管成形术后中位162天出现复发症状，静脉造影证实复发静脉狭窄。经皮腔内血管成形术后6、12、36、60和84个月的主要通畅率分别为92%、86%、85%、84%和83%。
静脉型胸廓出口综合征手术减压后残余静脉狭窄可在90天内通过经皮腔内血管成形术安全有效地治疗，以实现较高的长期通畅率。
