改良单期血管射流溶栓术治疗髂静脉压迫综合征急性髂股静脉血栓失败的多因素分析。

IF 1.6 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Phlebology Pub Date : 2023-03-01 DOI:10.1177/02683555221149587
Tianan Huang, Wenbin Ding, Yonghai Jin, Jie Jin, Xiaowen Deng, Li Liang, Zhuo Chen, Xin Hong
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引用次数: 0

摘要

目的:探讨改良单期血管射流溶栓取栓联合定向髂静脉支架置入、定向滤过器取栓治疗髂静脉压迫合并髂股静脉血栓形成失败的危险因素。方法:2017年9月至2021年9月,回顾性分析278例DVT患者,其中203例符合纳入条件。所有患者均尝试改良的单期血管射流溶栓术联合定向髂静脉支架置入术、定向滤过器取出治疗。分析两组围手术期因素:1组改良单疗程治疗成功,2组改良单疗程治疗失败。采用logistic回归分析评价失败组的高危因素。结果:改良单疗程治疗失败48例,失败率达23.64%。单因素分析显示与失败相关的独立危险因素有病程大于7天、腰椎退变相关髂静脉压迫综合征(dIVCS)、静脉顺行、球囊辅助破裂血栓、抽吸时间5个(p < 0.05)。Logistic回归分析表明,病程超过7天(OR = 19.642.95%CI:6.776 ~ 56.933)、dIVCS (OR = 11.586.95%CI:4.016 ~ 33.427)是改良单次治疗失败的高危因素,顺行静脉通路(OR = 0.171.95%CI:0.047 ~ 0.614)和球囊辅助破裂血栓(OR = 0.157.95%CI:0.045 ~ 0.542)是治疗失败的保护因素(p < 0.05)。结论:改良单期血管射流溶栓联合定向髂静脉支架置入术、定向滤过器置入术治疗髂静脉压迫综合征(IVCS)失败的高危因素是病程长和dIVCS。但是,顺行静脉通路和术中球囊辅助破栓可以提高改良单次治疗的成功率。
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Multi-factor analysis of failure for modified single-session Angiojet rheolytic thrombectomy in treatment of acute iliofemoral venous thrombosis from iliac vein compression syndrome.

Purpose: To explore the risk factors of failure for modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval in the treatment of iliac vein compression with iliofemoral vein thrombosis.

Methods: During September 2017 to September 2021, 278 patients with DVT were retrospectively analyzed and 203 were eligible for inclusion. All patients were tried to take modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval treatment. The perioperative factors were analyzed between groups: group 1-modified single-session therapy succeed, and group 2-modified single-session therapy failed. The high risk factors of failure group were evaluated by logistic regression analysis.

Results: 48 patients failed in modified single-session therapy, up to 23.64%. Single factor analysis indicated that there were five independent risk factors related with the failure (p < 0.05), including course of disease longer than 7 days, lumbar degeneration-related iliac vein compression syndrome (dIVCS), antegrade vein access, balloon-assisted cracking thrombus, and suction time. Logistic regression analysis indicated that course of disease longer than 7 days (OR = 19.642.95%CI:6.776∼56.933), dIVCS (OR = 11.586.95%CI:4.016∼33.427) were high risk factors for modified single-session therapy failed, antegrade vein access (OR = 0.171.95%CI:0.047∼0.614) and balloon-assisted cracking thrombus (OR = 0.157.95%CI:0.045∼0.542) were protective factors for therapy failure (p < 0.05).

Conclusions: Long course of disease and dIVCS are the high risk factors for failure of modified single-session Angiojet rheolytic thrombectomy combined with directed iliac vein stenting, directed filter retrieval in the treatment of iliac vein compression syndrome (IVCS). But, antegrade vein access and balloon-assisted cracking thrombus intraoperatively may improve the success rate of modified single-session treatment.

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来源期刊
Phlebology
Phlebology 医学-外周血管病
CiteScore
3.30
自引率
11.80%
发文量
84
审稿时长
6-12 weeks
期刊介绍: The leading scientific journal devoted entirely to venous disease, Phlebology is the official journal of several international societies devoted to the subject. It publishes the results of high quality studies and reviews on any factor that may influence the outcome of patients with venous disease. This journal provides authoritative information about all aspects of diseases of the veins including up to the minute reviews, original articles, and short reports on the latest treatment procedures and patient outcomes to help medical practitioners, allied health professionals and scientists stay up-to-date on developments. Print ISSN: 0268-3555
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