Journal of vascular surgery. Venous and lymphatic disorders最新文献

英文中文

Frequency of left common iliac vein compression in asymptomatic adolescents and young adults 无症状青少年和青壮年左髂总静脉受压的频率。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-20 DOI: 10.1016/j.jvsv.2025.102282

Kevin Wang MD , Luie Siegel BA , Alexis Betancourt MD , Nicole A. Keefe MD , Gloria Salazar MD , Sydney Browder BS , William A. Marston MD

Objective

Venous compression at the iliac confluence is a reported risk factor for deep vein thrombosis, with venous stenting as the standard management for relieving this compression. Kibbe et al demonstrated that left common iliac vein (LCIV) compression is present in 35.3% of asymptomatic patients. However, this study included only adults with an average age of 40 years. The iliac vein confluence in patients under 21 years with no symptoms attributable to venous disease was evaluated in this study. The study goal is to determine prevalence of LCIV narrowing in patients under age 21 years, and as such, assist in determining the appropriate treatment for iliac vein compression in this patient population.

Methods

A retrospective review of patients aged 13-20 undergoing abdominal/pelvic computed tomography (CT) imaging for nonvascular indications was performed. This group was compared with patients aged 35 to 65 years undergoing CT imaging for similar reasons. Axial CT images were reviewed by two independent examiners to identify the diameter of the noncompressed left and right CIVs below the confluence and the diameter of the LCIV at the site of compression between the right common iliac artery and spine.

Results

A total of 122 patients aged 13 to 20 years were identified with high-quality CT imaging and no venous symptoms for image review. Mean LCIV diameter was 12.7 ± 2.5 mm, and mean right CIV diameter was 13.1 ± 2.2 mm. The diameter of the LCIV at the confluence was 4.2 ± 1.8 mm, resulting in a mean diameter stenosis of the LCIV of 69.4% ± 12.6%. In this population, 55.7% of patients were found to have ≥70% stenosis of the LCIV on CT imaging compared with 1.7% of patients aged 35 to 65 years (P < .001). There was no statistical difference in the percentage of LCIV stenosis in young patients based on body mass index, gender, race, or ethnicity.

Conclusions

Severe compression of the LCIV at the iliac confluence was identified in over 50% of asymptomatic patients aged 13 to 20 years on CT imaging performed for nonvascular reasons. This suggests that narrowing of the LCIV is a normal anatomic finding in this age group. The incidence of severe compression is significantly lower in older asymptomatic persons. In young persons, the high incidence of iliac vein compression on CT imaging suggests that this finding may not be a significant risk factor for deep vein thrombosis or limb symptoms, questioning the need for routine intervention for compression correction in this patient population.

目的：据报道，髂汇合处静脉压迫是深静脉血栓形成（DVT）的危险因素，静脉支架置入术是缓解这种压迫的标准方法。Kibbe等人证明，35.3%的无症状患者存在左髂总静脉（LCIV）压迫。然而，这项研究只包括平均年龄为40岁的成年人。本研究评估了21岁以下无静脉疾病症状患者的髂静脉汇合情况。该研究的目的是确定21岁以下患者LCIV狭窄的患病率，因此，有助于确定该患者群体中髂静脉压迫的适当治疗方法。方法：回顾性分析13-20岁接受腹部/盆腔CT检查的非血管指征患者。将这组患者与35-65岁因类似原因接受CT成像的患者进行比较。由2名独立检查人员复查轴位CT图像，以确定汇合处以下未受压的左右civ的直径以及右侧髂总动脉与脊柱之间受压部位的LCIV的直径。结果：122例年龄13-20岁的患者均有高质量的CT成像，影像学复习无静脉症状。左髂总静脉（LCIV）平均直径12.7±2.5 mm，右髂总静脉平均直径13.1±2.2 mm。汇合处LCIV直径为4.2±1.8 mm，平均狭窄率为69.4%±12.6%。在该人群中，55.7%的患者CT成像发现LCIV狭窄≥70%，而35-65岁患者的这一比例为1.7% （P < .001）。基于体重指数、性别、种族或民族，年轻患者LCIV狭窄的百分比没有统计学差异。结论：在13-20岁的无症状患者中，超过50%的患者在非血管原因的CT成像中发现髂汇合处LCIV严重压迫。这表明LCIV变窄在这个年龄组是正常的解剖发现。老年人严重压迫的发生率明显较低。在年轻人中，髂静脉压迫在CT成像上的高发表明，这一发现可能不是深静脉血栓形成或肢体症状的重要危险因素，这就质疑了在这一患者群体中进行常规干预以纠正压迫的必要性。

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引用次数: 0

Venous bypass using the internal jugular vein as the outflow tract for treating central venous stenosis and cephalic arch stenosis in hemodialysis access 以颈内静脉为流出道的静脉旁路治疗血液透析通路中中心静脉狭窄和头弓狭窄。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-18 DOI: 10.1016/j.jvsv.2025.102280

Mo Wang MD , Peng Lu MD , Quanming Li MD , Chang Shu MD , Yang Zhou MD , Tun Wang MD

Objective

Central venous stenosis (CVS) and cephalic arch stenosis (CAS) remain significant issues in the long-term management of hemodialysis access. Surgical bypass serves as a crucial option for symptom relief and access preservation when endovascular treatments fail. This study aimed to evaluate the effectiveness and safety of using the internal jugular vein (IJV) as the outflow tract in bypass surgery for CVS and CAS.

Methods

From December 2021 to September 2024, 21 patients undergoing hemodialysis who developed CVS (n = 15) or CAS (n = 6), were undertaken. Extra-anatomic venous bypass using the IJV were performed. Before surgical bypass, all patients had computed tomography angiography (CTA) and bilateral venograms of the upper central venous system. Color Doppler ultrasound was used to measure flow volume. A literature review was conducted to analyze the outcomes of previous studies that using venous bypass for the treatment of CVS in patients with upper extremity hemodialysis access.

Results

Technical success was achieved in all cases. Fifteen cases presented with CVS (11 men and 4 women, with a mean age of 56 ± 11 years [range, 37-82 years]) were treated by six surgical approaches include cephalic vein to contralateral-IJV bypass (n = 3), axillary vein to contralateral-IJV bypass (n = 5), external jugular vein to contralateral-IJV bypass (n = 2), IJV to contralateral-IJV bypass (n = 2), axillary vein to ipsilateral-IJV bypass (n = 1), cephalic vein to ipsilateral-IJV bypass (n = 1), and arteriovenous graft to ipsilateral-IJV bypass (n = 1). The median follow-up was 22 months (interquartile range, 12-24 months). The primary patency rate and secondary patency were 79% and 79% at 1 year and 65% and 79% at 2 years. Six patients presented with CAS (2 men and 4 women, with a mean age of 51 ± 9 years [range, 38 to 59 years]) and were treated by cephalic vein to ipsilateral-IJV bypass (n = 6). The median follow-up was 22 months (interquartile range, 15-26 months). The primary patency rate and secondary patency were 100% and 100% at 1 year and 60% and 60% at 2 years. All patients showed significant symptom improvement postoperation, with no perioperative mortality.

Conclusions

Extra-anatomic venous bypass using the IJV as outflow tract is an effective and safe alternative, providing good graft patency and low postoperative complications during midterm follow-up. Careful selection of inflow and outflow tracts is crucial for optimal outcomes.

目的：中心静脉狭窄（CVS）和头弓狭窄（CAS）仍然是血液透析通路长期管理的重要问题。当血管内治疗失败时，旁路手术是缓解症状和保留通道的关键选择。本研究旨在评价颈内静脉（IJV）作为体外流出道在CVS和CAS旁路手术中的有效性和安全性。方法：从2021年12月至2024年9月，对21例发生CVS （n=15）或CAS （n=6）的血液透析患者进行研究。采用IJV进行解剖外静脉旁路。手术前，所有患者均行计算机断层血管造影（CTA）和双侧上中心静脉系统静脉造影。彩色多普勒超声测量血流容量。我们回顾文献，分析以往研究中使用静脉旁路治疗上肢血液透析通路患者CVS的结果。结果：所有病例均取得技术成功。15例出现CVS(11男性和4女性平均年龄为56±11年,37到82年)是由六个外科治疗方法包括contralateral-IJV头静脉旁路(n = 3),腋静脉侧-IJV绕过(n = 5),颈外静脉侧-IJV绕过(n = 2), IJV侧-IJV绕过(n = 2),腋静脉ipsilateral-IJV绕过(n = 1),头静脉ipsilateral-IJV绕过(n = 1),和AVG侧-IJV旁路(n = 1)。中位随访时间为22个月（IQR， 12 ~ 24个月）。一期通畅率和二期通畅率在1年分别为79%和79%，2年分别为65%和79%。6例CAS患者（男2例，女4例，平均年龄51±9岁，年龄范围38 ~ 59岁）采用头静脉至同侧ijv旁路治疗（n=6）。中位随访时间为22个月（IQR， 15 ~ 26个月）。一期通畅率为100%，二期通畅率为100%，一期通畅率为60%，二期通畅率为60%。所有患者术后症状均有明显改善，无围手术期死亡。结论：在中期随访中，以IJV为流出道的解剖外静脉旁路是一种安全有效的选择，移植物通畅良好，术后并发症少。仔细选择流入和流出通道对于获得最佳结果至关重要。

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引用次数: 0

Rationale for glue embolization rather than foam sclerosis in the endovascular treatment of pelvic reservoir in pelvic venous disorders 在盆腔静脉疾病的腔内治疗中采用胶栓塞而不是泡沫硬化的理由

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-13 DOI: 10.1016/j.jvsv.2025.102216

Romaric Loffroy MD, PhD

引用次数: 0

Natural course of portal vein aneurysm - does morphology matter? 门静脉动脉瘤的自然病程——形态学重要吗？

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-13 DOI: 10.1016/j.jvsv.2025.102231

Admir Kurtcehajic PhD, Enver Zerem MD, Suad Kunosic PhD, Ervin Alibegovic MD, Predrag Jovanovic MD, Ahmed Hujdurovic PhD

引用次数: 0

Events of Interest 关注的事件

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-13 DOI: 10.1016/S2213-333X(25)00102-7

引用次数: 0

Information for Readers 读者资讯

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-13 DOI: 10.1016/S2213-333X(25)00101-5

引用次数: 0

Commentary on compression after radiofrequency ablation: Limitations and research gaps 射频消融后的压缩：局限性和研究空白

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-13 DOI: 10.1016/j.jvsv.2025.102218

Yang Xiao PhD, Shi Hongshuo PhD, Liu Guobin PhD

引用次数: 0

Successful treatment of severe venous leg ulcers and diabetic foot ulcers using ozone 应用臭氧成功治疗严重静脉性腿溃疡（VLUs）和糖尿病足溃疡（DFUs）。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-13 DOI: 10.1016/j.jvsv.2025.102278

Giuseppe Masiello MD , Marianno Franzini MD , Umberto Tirelli MD , Tommaso Richelmi MD , Luigi Valdenassi MD , Francesco Vaiano MD , Salvatore Chirumbolo PhD

Background

Venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) are chronic wounds associated with significant morbidity, high recurrence rates, and poor healing outcomes. Conventional treatments often fail to achieve satisfactory results, leading to prolonged pain, infection risks, and reduced quality of life. Oxygen-ozone therapy (OOT) has emerged as a potential adjunct to conventional wound care, with antimicrobial, anti-inflammatory, and tissue-regenerating properties. This study evaluates the efficacy of OOT in treating severe VLUs and DFUs.

Methods

A total of 25 patients (mean age, 57.2 ± 10.51) with refractory VLUs (n = 18) or DFUs (n = 7) received OOT alongside standard care. Treatment protocols included major autohemotherapy (O₂-O₃-MAHT), topical ozone application, and localized ozone injections. Clinical assessments included pain scoring (Numeric Rating Scale), microbiological evaluations, and logistic regression analysis to determine healing rates.

Results

At 4 weeks, pain scores decreased by 73.27% (P < .0001), and 92% of septic lesions showed negative bacterial cultures. Logistic regression analysis indicated a significant improvement in healing rates (P < .0001), with 80% of patients achieving complete wound closure. Inflammatory markers were reduced, and tissue regeneration was enhanced.

Conclusions

OOT demonstrated substantial efficacy in reducing infection, alleviating pain, and promoting wound healing in patients with severe VLUs and DFUs, restoring their healthy, normal limbs. These findings support the use of OOT as a valuable adjunctive treatment. Further large-scale, randomized trials are needed to optimize treatment protocols and confirm long-term benefits.

背景：下肢静脉溃疡（VLUs）和糖尿病足溃疡（DFUs）是一种慢性伤口，发病率高，复发率高，愈合效果差。常规治疗往往不能达到令人满意的效果，导致疼痛延长，感染风险，并降低生活质量。氧臭氧疗法（OOT）已成为传统伤口护理的潜在辅助手段，具有抗菌、抗炎和组织再生的特性。本研究评估OOT治疗严重vlu和dfu的疗效。方法：共有25例难治性vlu （n=18）或dfu （n=7）患者（平均年龄57.2±10.51 SD）在标准治疗的同时接受OOT治疗。治疗方案包括主要的自体血液治疗（O2-O3-MAHT），局部臭氧应用和局部臭氧注射。临床评估包括疼痛评分（数值评定量表，NRS）、微生物学评估和逻辑回归分析以确定治愈率。结果：4周时疼痛评分下降73.27% (p < 0.0001)， 92%脓毒症灶细菌培养阴性。Logistic回归分析显示，愈合率显著提高（p < 0.0001）， 80%的患者伤口完全愈合。炎症标志物减少，组织再生增强。结论：OOT在严重vlu和dfu患者中具有减少感染、减轻疼痛和促进伤口愈合的显著疗效。这些发现支持OOT作为一种有价值的辅助治疗。需要进一步的大规模随机试验来优化治疗方案并确认长期效益。

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引用次数: 0

Vein-first embolization is superior to transarterial approach in type IIIb arteriovenous malformations 静脉先栓塞优于经动脉栓塞治疗IIIb型动静脉畸形。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-06 DOI: 10.1016/j.jvsv.2025.102274

Jun Gon Kim MD , Sang Yub Lee MD , Kwang Bo Park MD , Dongho Hyun MD , Sung Wook Shin MD , Sung Ki Cho MD , Hong Suk Park MD , Sung Wook Choo MD , Young Soo Do MD

Objective

To propose a modified treatment concept for type IIIb arteriovenous malformation (AVM), involving a vein-first (VF) strategy that focuses on direct puncture and coil embolization of dilated veins, followed by ethanol injection from the vein to feeding arteries. This retrospective study evaluated the safety and efficacy of this approach.

Methods

A total of 117 patients (55 males; median age, 27 years) with type IIIb AVMs were retrospectively reviewed. Patients were divided into two groups: a transarterial (TA) embolization-dominant group and a VF group, which underwent direct puncture of veins with coil embolization followed by ethanol injection. AVM characteristics, embolization techniques, number of treatment sessions, angiographic outcomes, and procedure-related adverse events were analyzed.

Results

A total of 515 procedures were performed: 117 in the VF group (n = 41) and 343 in the TA group (n = 76). No significant differences in demographics or AVM characteristics were found. The VF group achieved significantly better treatment outcomes than the TA group (88% vs 51% achieving >90% lesion improvement; P = .001). The VF group required a median of 4.2 treatment sessions per patient vs 4.5 in the TA group, and used 129 mL vs 141 mL of ethanol; those differences were not statistically significant. Procedure-related adverse events were significantly lower in the VF group (11%) than in the TA group (22.3%; P = .0009).

Conclusions

The VF strategy for type IIIb AVM achieved better outcomes and fewer adverse events than conventional TA embolization technique.

目的：提出一种改进的IIIb型动静脉畸形（AVM）的治疗理念，包括“静脉优先”策略，重点是直接穿刺和线圈栓塞扩张静脉，然后从静脉注射乙醇到供血动脉。本回顾性研究评估了该方法的安全性和有效性。材料与方法：回顾性分析117例IIIb型AVM患者（男性55例，中位年龄27岁）的临床资料。患者分为两组：经动脉栓塞为主组和静脉优先组，直接穿刺静脉栓塞后注射乙醇。分析AVM的特征、栓塞技术、治疗次数、血管造影结果和手术相关的不良事件。结果：共进行515例手术：VF组117例（n = 41）， TA组343例（n = 76）。在人口统计学和AVM特征上没有发现显著差异。VF组的治疗效果明显好于TA组（88% vs 51%病变改善，P = 0.001）。VF组每名患者平均需要4.2次治疗，而TA组为4.5次，使用129 mL乙醇对141 mL乙醇；这些差异没有统计学意义。VF组手术相关不良事件发生率（11%）显著低于TA组(22.3%；P = 0.0009)。结论：与传统的TA栓塞技术相比，静脉优先策略治疗IIIb型AVM具有更好的疗效和更少的不良事件。

{"title":"Vein-first embolization is superior to transarterial approach in type IIIb arteriovenous malformations","authors":"Jun Gon Kim MD , Sang Yub Lee MD , Kwang Bo Park MD , Dongho Hyun MD , Sung Wook Shin MD , Sung Ki Cho MD , Hong Suk Park MD , Sung Wook Choo MD , Young Soo Do MD","doi":"10.1016/j.jvsv.2025.102274","DOIUrl":"10.1016/j.jvsv.2025.102274","url":null,"abstract":"<div><h3>Objective</h3><div>To propose a modified treatment concept for type IIIb arteriovenous malformation (AVM), involving a vein-first (VF) strategy that focuses on direct puncture and coil embolization of dilated veins, followed by ethanol injection from the vein to feeding arteries. This retrospective study evaluated the safety and efficacy of this approach.</div></div><div><h3>Methods</h3><div>A total of 117 patients (55 males; median age, 27 years) with type IIIb AVMs were retrospectively reviewed. Patients were divided into two groups: a transarterial (TA) embolization-dominant group and a VF group, which underwent direct puncture of veins with coil embolization followed by ethanol injection. AVM characteristics, embolization techniques, number of treatment sessions, angiographic outcomes, and procedure-related adverse events were analyzed.</div></div><div><h3>Results</h3><div>A total of 515 procedures were performed: 117 in the VF group (n = 41) and 343 in the TA group (n = 76). No significant differences in demographics or AVM characteristics were found. The VF group achieved significantly better treatment outcomes than the TA group (88% vs 51% achieving >90% lesion improvement; <em>P</em> = .001). The VF group required a median of 4.2 treatment sessions per patient vs 4.5 in the TA group, and used 129 mL vs 141 mL of ethanol; those differences were not statistically significant. Procedure-related adverse events were significantly lower in the VF group (11%) than in the TA group (22.3%; <em>P</em> = .0009).</div></div><div><h3>Conclusions</h3><div>The VF strategy for type IIIb AVM achieved better outcomes and fewer adverse events than conventional TA embolization technique.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"13 5","pages":"Article 102274"},"PeriodicalIF":2.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peripheral thrombus extension is associated with increased risk of recurrent deep venous thrombosis in patients undergoing percutaneous thrombectomy for iliofemoral deep venous thrombosis 外周血栓延伸与经皮髂股深静脉血栓切除术患者DVT复发风险增加相关。

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders

Pub Date : 2025-06-06 DOI: 10.1016/j.jvsv.2025.102277

Moira A. McGevna BA , Molly Ratner MD , Caron B. Rockman MD , Thomas S. Maldonado MD , Keerthi B. Harish MD, MBA , Anil Hingorani MD , Glenn R. Jacobowitz MD , Mikel Sadek MD , Todd Berland MD , Karan Garg MD

Objective

Patients presenting with iliofemoral deep venous thrombosis (DVT) often undergo percutaneous thrombectomy intending to prevent post-thrombotic syndrome. However, the relationship between the extent of DVT and outcomes after thrombectomy has not been explored. The objective of this study was to compare rates of post-thrombectomy DVT recurrence between patients with isolated iliofemoral DVT and patients with iliofemoral DVT and extension more peripherally.

Methods

We conducted a single-center, retrospective analysis of all patients who underwent thrombectomy for iliofemoral DVT from 2014 to 2023. Patients were stratified into two cohorts: (1) iliofemoral DVT without popliteal/tibial extension or (2) iliofemoral DVT with popliteal/tibial extension. The primary outcome was acute DVT recurrence and multivariable analysis was performed to identify risk factors for recurrence. The χ² test and t test were calculated for categorical and continuous data, respectively. Kaplan-Meier analysis was used to compare rates of acute DVT and chronic venous changes postoperatively. A P value of <.05 was considered statistically significant.

Results

We identified 222 patients during the study period (76 isolated iliofemoral DVT vs 146 iliofemoral DVT with peripheral extension) with a median follow-up of 19 months. Patients who presented with iliofemoral DVT with peripheral extension were more likely to be older (57 years vs 50 years; P = .004), have hypertension (64% vs 41%; P = .001) or hyperlipidemia (58% vs 40%; P = .01), and to have had surgery within the prior 6 months (29% vs 17%; P = .04). Among the female patients, those on hormone therapy were more likely to have isolated iliofemoral DVT (17% vs 3%; P < .001). Patients with iliofemoral DVT with peripheral extension had a greater chance of developing recurrent acute DVT (48% vs 20%; P < .001) and chronic venous changes (51% vs 30%; P = .004) during follow-up. Multivariable analysis showed a significant correlation between iliofemoral DVT with peripheral extension (odds ratio, 3.8; 95% confidence interval, 1.7-8.7; P = .001) and acute DVT recurrence. There were no differences in the rates of reintervention or death.

Conclusions

A more extensive peripheral thrombus burden was associated with higher rates of follow-up DVT recurrence in patients undergoing thrombectomy for iliofemoral DVT. These findings suggest that such patients may require closer follow-up and more aggressive anticoagulation therapy postoperatively. Moreover, our results provide a framework for further studies to specifically study the role peripheral thrombus may play in venous hemodynamics and the development of recurrent DVT and, ultimately, post-thrombotic syndrome.

目的：髂股深静脉血栓形成（DVT）的患者经常接受经皮血栓切除术，以预防血栓后综合征（PTS）。然而，深静脉血栓程度与取栓后预后之间的关系尚未探讨。本研究的目的是比较孤立性髂股深静脉血栓切除术后DVT复发率和髂股深静脉血栓并向外延伸的患者。方法：我们对2014-2023年接受髂股深静脉血栓切除术的所有患者进行了单中心回顾性分析。患者被分为两组：(1)髂股DVT不伴腘/胫骨延伸；(2)髂股DVT伴腘/胫骨延伸。主要结果是急性深静脉血栓复发，并进行多变量分析以确定复发的危险因素。对分类数据和连续数据分别进行卡方检验和t检验。Kaplan-Meier分析比较急性深静脉血栓形成和术后慢性静脉改变的发生率。p值结果：222例患者在研究期间被确定（76例孤立性髂股DVT vs 146例伴外周延伸的髂股DVT），中位随访时间为19个月。髂股深静脉血栓伴外周延伸的患者年龄较大（57岁vs. 50岁，p=0.004），有高血压（64% vs. 41%, p=0.001）或高脂血症（58% vs. 40%, p=0.01），且在前6个月内接受过手术（29% vs. 17%, p=0.04）。在女性患者中，接受激素治疗的患者更有可能发生孤立性髂股深静脉血栓（17% vs. 3%）。结论：髂股深静脉血栓切除术患者中，更广泛的外周血栓负担与更高的随访DVT复发率相关。这些发现提示此类患者可能需要更密切的随访和更积极的术后抗凝治疗。此外，我们的研究结果为进一步研究外周血栓在静脉血流动力学和复发性深静脉血栓的发展以及最终的PTS中可能发挥的作用提供了一个框架。

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