[通过同侧大隐静脉途径进行髂静脉成型和支架植入术在日间治疗模式中的应用]。

Q3 Medicine 北京大学学报(医学版) Pub Date : 2024-04-18
Qichen Feng, Shuo Gai, Changming Wang, Xuan Li
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引用次数: 0

摘要

目的探讨髂静脉成型和支架植入术在髂静脉狭窄患者日间治疗模式中的可行性和近期疗效:回顾性分析2017年2月至2022年3月在同侧大隐静脉入路进行的髂静脉成型和支架植入术的病历。21例病例中,男性6例,女性15例。年龄从37岁到79岁不等[(62.5 ± 10.2)岁]。21例肢体中,16例患者的狭窄仅涉及髂总静脉,2例患者的狭窄涉及髂总静脉和髂外静脉,3例患者的狭窄同时涉及髂总静脉和髂外静脉。髂静脉成型术和髂静脉支架植入术都是通过同侧大隐静脉入路进行的。单纯髂静脉狭窄伴大隐静脉瓣膜功能不全的患者还同时接受了大隐静脉射频闭合和挠曲静脉硬化治疗。术后患者均接受了常规的直接口服抗凝药物治疗和应激治疗。所有患者的住院时间均少于 24 小时:所有 21 名患者的手术都很成功(成功率为 100%),术中未出现任何并发症。术后即刻出现的并发症为 1 例穿刺点出血。绷带纱布完全湿透。重新按压 5 分钟后出血停止。所有患者的住院时间均少于 24 小时:术后 3 个月的随访率为 100%。绝对有效 18 例(18/21,85.7%)。相对有效(术后仍有肿胀,但程度较轻)3 例(3/21,14.3%)。大隐静脉射频治疗患者的髂静脉支架通畅,大隐静脉主干闭合良好。术后 6 个月的随访率为 71.4%(15/21)。其中,14 例(14/15,93.3%)绝对有效。1例(1/15,6.7%)相对有效(术后仍有肿胀,但程度较轻)。大隐静脉射频治疗患者的髂静脉支架无再狭窄或阻塞,大隐静脉主干闭合良好:结论:髂静脉狭窄的介入治疗技术在日间治疗模式下是可行的,优势明显,近期疗效令人满意。
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[Application of iliac vein molding and stent implantation through the ipsilateral great saphenous vein approach in daytime treatment mode].

Objective: To explore the feasibility and recent efficacy of iliac vein molding and stenting in daytime treatment mode in patients with iliac vein stenosis.

Methods: Medical records of iliac vein molding and stenting performed in the ipsilateral great saphenous vein approach conducted from February 2017 to March 2022 were retrospective reviewed. There were 21 cases, 6 males and 15 females. Age ranged from 37 to 79 years [(62.5 ± 10.2) years]. The stenosis in the 21 limbs simply involved the common iliac veins in 16 patients, 2 patients had the simple and external iliac veins, and both the total and external iliac veins in 3 patients. Both iliac vein molding and iliac vein stenting were performed through the ipsilateral great saphenous vein approach. The patients with simple iliac vein stenosis with great saphenous vein valve insufficiency also underwent radiofrequency closure of great saphenous vein and flexural vein sclerosis therapy simultaneously. Regular postoperative direct oral anticoagulants therapy and stress therapy were followed. All the patients were hospitalized for less than 24 h.

Results: All the 21 patients operations were successful (the success rate was 100%), without any intraoperative complications. Immediate postoperative complications were puncture point bleeding in 1 case. The bandage gauze was completely wet. The bleeding was stopped after 5min of recompression. All the patients were hospitalized for less than 24 h. Follow-up results: The 3-month follow-up rate after operation was 100%. Absolute effective 18 cases (18/21, 85.7%). Relatively effective(postmentation still after surgery, but with less extent) in 3 cases (3/21, 14.3%). The iliac vein stents were unobstructed, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment. The 6-month follow-up rate after operation was 71.4%(15/21). Of these, 14 cases (14/15, 93.3%) were absolutely effective. Relatively effective(postmentation still after surgery, but with less extent) in 1 case (1/15, 6.7%). The iliac vein stents were no restenosis or obstruction, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment.

Conclusion: The interventional treatment technique of iliac vein stenosis is feasible in the daytime treatment mode, with clear advantages and satisfactory recent efficacy.

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北京大学学报(医学版)
北京大学学报(医学版) Medicine-Medicine (all)
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0.80
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0.00%
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9815
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