血管内介入治疗滤器源性下腔髂静脉长段阻塞8例.docxVIP

血管内介入治疗滤器源性下腔-骼静脉 长段阻塞8例 施万印陈亮刘长建顾建平 南京医科大学附属南京医院（南京市第一医院）介入 血管科南京大学医学院附属鼓楼医院血管外科 摘要： 目的探讨血管内介入治疗滤器源性下腔-骼静脉长段阻塞的可行性和安全性。方 法2014年1月至2016年10月采用经皮腔内血管成形术（PTA）和支架植入术治 疗8例下腔静脉滤器置入后慢性下腔-骼静脉长段闭塞患者。收集8例患者临床 及影像学资料，对血管内介入治疗方法、技术成功率、并发症发生率及随访情况 进行统计分析。结果8例患者闭塞段血管均成功开通。7例球囊成形结合植入支 架术后即刻造影显示支架位置良好，支架内血流通畅，侧支血管减少；1例球囊 成形结合支架植入术后发牛急性支架内血栓形成，经导管直接溶栓2 d后复查造 影显示支架内血栓完全溶解，血流恢复通畅。术后随访丁3个月，平均 （4.7土3.9）个月。至末次随访，8例患者CT及下肢静脉造影均显示支架在位良 好，其中3例支架内可见内膜轻度增生，但血流均通畅。结论滤器长期置入可 导致慢性下腔-骼静脉长段闭塞。球囊成形及支架植入可有效开通闭塞血管，是 一种安全可行的方法。 关键词： 下腔静脉;骼静脉;滤器;血管内治疗; 作者简介：刘长建 E-mail: lcj_nj@163. com 收稿日期：2016-12-29 基金：国家自然科学基金 Endovascular treatment for filter-related long segment obstruetion of IVC and iliac vein: preliminary resuIts in 8 patients SHI Wanyin CHEN Liang LIU Changjian GU Jianping Department of Vascular and Intervatiorial Radiology, Nanjing First Hospital, Nanjing University; Abstract： Objective To evaluate the feasibi1ity and safety of endovascular in terve nt ion for the t rea tment of f 订 ter - related long segme nt obstruction of IVC and iliac vein. Methods From January 2014 to Octobcr 2016, a total of 8 patients with filter-related chronic long segment obstruction of IVC and iliac vein were treated with percutaneous transcatheter angioplasty (PTA) and ste nt impla ntati on. The cl inical data a nd i mag in g material s were collected. The endovascular interventional treatment methods were discussed, and the technical success rate, procedure-related complications and follow-up results were analyzed. Results Successful recanalization of the obstructed IVC-iliac vein segment was achieved in al 1 8 patients. In 7 patients, angiography performed immediately after PTA and stent implantation showed that the blood flow in the stent was smooth and the collateral vessels were decreased. In one patient, acute in-stent thrombosis occurred after PTA and stent implantation, then catheter-directed thrombolysis had to be adopted, and angiography performed 2 days later indicated that in-stent thrombosis