Wilhelm K, Schild H, Bruch E, Mildenberger P, Strunk H, Textor J, Terjung B, Lorenz J
Radiologische Universitätsklinik Bonn.
Rofo. 1995 Jun;162(6):514-20. doi: 10.1055/s-2007-1015927.
Self-expandable metallic stents were used to treat patients with malignant venous obstructions to determine their effectiveness in producing symptomatic palliation.
20 patients with a total of 28 tumour-induced obstructions of the superior vena cava (n = 13), the inferior vena cava (n = 4), the subclavian (n = 4), the innominate (n = 5) and the iliac veins (n = 2) were treated with self-expandable metallic stents. 38 Gianturco stents and 21 Wallstents were applied. Patients were heparinised during the procedure and up to three days afterwards.
In all patients correct positioning of the stents was achieved. In 16 patients stent placement resulted in relief of their symptoms. In 8 patients the symptoms completely disappeared without recurrence until death as a result of tumour progression. The follow-up ranged from 10 days to 14 months. In 8 still living patients no re-obstruction occurred (follow-up average three months). In one patient thrombotic stent occlusion occurred 6 days after the procedure; the v. cava superior was reopened again by local urokinase therapy. Three patients finally developed re-occlusion due to tumour progression. In one patient stent placement was complicated by migration of the Gianturco stent one day after stent implantation and reocclusion of the subclavian vein.
The application of self-expandable metallic stents in patients with malignant venous obstruction is a useful palliative therapy.
使用自膨式金属支架治疗恶性静脉阻塞患者，以确定其缓解症状的有效性。
20例患者共28处由肿瘤引起的上腔静脉阻塞（n = 13）、下腔静脉阻塞（n = 4）、锁骨下静脉阻塞（n = 4）、无名静脉阻塞（n = 5）和髂静脉阻塞（n = 2），接受了自膨式金属支架治疗。应用了38枚Gianturco支架和21枚Wallstent支架。术中及术后三天内对患者进行肝素化处理。
所有患者支架均定位正确。16例患者支架置入后症状缓解。8例患者症状完全消失，直至因肿瘤进展死亡未复发。随访时间为10天至14个月。8例仍存活患者未发生再阻塞（随访平均三个月）。1例患者术后6天发生支架血栓形成闭塞；通过局部尿激酶治疗重新开通了上腔静脉。3例患者最终因肿瘤进展出现再阻塞。1例患者支架置入术后一天发生Gianturco支架移位并导致锁骨下静脉再次闭塞。
自膨式金属支架应用于恶性静脉阻塞患者是一种有效的姑息治疗方法。
