Schwarzenberg H, Link J, Müller-Hülsbeck S, Brossmann J, Palmié S, Schmid A, Heller M
Klinik für Radiologische Diagnostik, Universität Kiel.
Dtsch Med Wochenschr. 1996 Nov 8;121(45):1383-9. doi: 10.1055/s-2008-1043157.
To evaluate the patency of Wallstents implanted for the treatment of venous stenoses in patients with benign or malignant disease.
22 Wallstents (20 central venous; two peripheral) were implanted during a period of two years in 12 patients (nine men, three women; mean age 57.8 [26-76] years) with malignant venous stenoses (n = 9) or stenosed dialysis shunts (n = 3). Stent diameter ranged from 8-16 mm, length from 32-91 mm. Introduction of the stents were by percutaneous transfemoral catheterisation, in six patients with simultaneous wire placement from a cubital to the femoral vein. The superior vena cava was the involved vessel in six patients (in two each also the subclavian or brachiocephalic veins), in three only the subclavian vein, twice only the inferior vena cava and once the cephalic vein.
The patency of the stents was checked after 4.7 +/- 3.6 (1-14) months, in seven patients clinically, by digital subtraction phlebography in three, by computed tomography in two. In nine patients there was no evidence of obstruction to flow or flow was normal. Stent occlusion had occurred in three patients, 4, 9 and 14 months after placement. There were no complications. Five patients died after a mean period of 4.8 +/- 3.6 (1-6.5) months from the underlying disease, without symptoms of obstruction to flow.
Stent placement should be considered early, as it is a well-tolerated and effective palliative procedure for central venous stenoses associated with malignant disease or stenosis of dialysis shunts.
评估用于治疗良性或恶性疾病患者静脉狭窄的Wallstents支架的通畅情况。
在两年时间内，为12例患者（9例男性，3例女性；平均年龄57.8[26 - 76]岁）植入了22个Wallstents支架（20个中心静脉支架；2个外周静脉支架），这些患者患有恶性静脉狭窄（n = 9）或透析分流狭窄（n = 3）。支架直径为8 - 16毫米，长度为32 - 91毫米。通过经皮股动脉插管置入支架，6例患者同时从肘静脉至股静脉放置导丝。6例患者的受累血管为上腔静脉（其中2例还累及锁骨下静脉或头臂静脉），3例仅累及锁骨下静脉，2例仅累及下腔静脉，1例累及头静脉。
在4.7±3.6（1 - 14）个月后检查支架通畅情况，7例患者通过临床检查，3例通过数字减影静脉造影，2例通过计算机断层扫描。9例患者没有血流阻塞的证据或血流正常。3例患者在放置支架后4、9和14个月出现支架闭塞。无并发症发生。5例患者在平均4.8±3.6（1 - 6.5）个月后死于基础疾病，无血流阻塞症状。
对于与恶性疾病相关的中心静脉狭窄或透析分流狭窄，支架置入术是一种耐受性良好且有效的姑息治疗方法，应尽早考虑。
