血管内介入治疗滤器源性下腔-髂静脉长段阻塞8例

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1、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

2、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2d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（8

3、1541061）Endovasculartreatmentforfilter-relatedlongsegmentobstruetionofIVCandiliacvein:preliminaryresuItsin8patientsSHIWanyinCHENLiangLIUChangjianGUJianpingDepartmentofVascularandIntervatiorialRadiology,NanjingFirstHospital,NanjingUniversity;Abstract：ObjectiveToevaluatethefeasibi

4、1ityandsafetyofendovascularinterventionforthetreatmentoff订ter-relatedlongsegmentobstructionofIVCandiliacvein.MethodsFromJanuary2014toOctobcr2016,atotalof8patientswithfilter-relatedchroniclongsegmentobstructionofIVCandiliacveinweretreatedwithpercutaneoustranscatheterangioplasty(P

5、TA)andstentimplantation.Theclinicaldataandimagingmaterialswerecollected.Theendovascularinterventionaltreatmentmethodswerediscussed,andthetechnicalsuccessrate,procedure-relatedcomplicationsandfollow-upresultswereanalyzed.ResultsSuccessfulrecanalizationoftheobstructedIVC-iliacvein

6、segmentwasachievedinal18patients.In7patients,angiographyperformedimmediatelyafterPTAandstentimplantationshowedthatthebloodflowinthestentwassmoothandthecollateralvesselsweredecreased.Inonepatient,acutein-stentthrombosisoccurredafterPTAandstentimplantation,thencatheter-directedthr

7、ombolysishadtobeadopted,andangiographyperformed2dayslaterindicatedthatin-stentthrombosiswascompletelydissolvedandthebloodflowresumedsmoothly.Thepatientswerefollowedupfor2-13months,withameanof(4・7±3.9)months.ReexaminationwithbothCTandvenographyoflowerlimbshowedthatthestentwaskept

8、ingoodpositiontothelastvisitinall8patients.Slig