临床研究(Clinical Research)

Cockett综合征诱发下肢深静脉血栓形成的腔内治疗:附27例报告

Published at: 2016年第25卷第9期

李振振 1 , 肖占祥 1 , 李灼日 1 , 曾昭凡 1 , 吴鸿飞 1 , 张文波 1
1 海南省人民医院 血管外科,海南 海口 570311
通讯作者 振振 李 Email: 18876087830@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.09.021
基金:
海南省自然科学基金资助项目 814317

摘要

目的:探讨Cockett综合征(CS)诱发下肢深静脉血栓形成(DVT)的腔内治疗方法。方法:回顾性分析2012年7月—2016年4月收治的27例CS诱发DVT的患者资料。所有患者均行下肢静脉造影;18例置入临时性下腔静脉滤器,并行髂静脉球囊扩张成形术及深静脉置管溶栓,其中6例植入支架;7例患者行下肢深静脉造影及置管溶栓;2例患者行浅静脉溶栓。结果:23例术后恢复良好,复查造影发现深静脉通畅,血栓基本消失,4例出院时肢体有轻-中度肿胀;术后2例因滤器内血栓而转为永久性滤器;围手术期无肺栓塞及严重出血事件发生。所有患者均获随访,随访时间1个月至3年(平均18个月),3例活动后仍有下肢肿胀,余24例下肢无肿胀,缓解率达88.9%;彩超发现4例髂静脉闭塞,23例髂静脉通畅,通畅率达85.2%。结论:腔内治疗作为一种安全、微创的方式,可有效治疗CS合并DVT。


Endovascular therapy of deep venous thrombosis induced by Cockett's syndrome: a report of 27 cases

Abstract

Objective: To investigate the endovascular treatment methods for deep venous thrombosis (DVT) of the lower extremities induced by Cockett’s syndrome (CS). Methods: The clinical data of 27 patients with DVT caused by CS treated from July 2012 to April 2016 were retrospectively analyzed. Of the patients, all cases received leg venography; 18 cases underwent placement of a temporary inferior vena cava filter, followed by iliac vein balloon dilatation and catheter-directed thrombolysis (CDT) for deep vein thrombosis, and 6 of them had stent placement; 7 cases underwent venography of the deep leg veins and simple deep vein CDT; 2 cases underwent only superficial venous thrombolysis. Results: Twenty-three patients recovered well after operation, and their deep veins were found patent by review venography, and the other 4 patients had mild to moderate leg swelling at discharge. The filters in 2 patients became permanent because of thrombus trapped inside the filter. No pulmonary embolism or critical bleeding occurred during the perioperative period. All patients were followed up for one month to 3 years (average of 18 months), of whom, 3 cases presented lower limb swelling after movement, but this did not occur in the other 24 cases, and remission rate was 88.9%; on duplex ultrasonic examination, the iliac vein was found to be occluded in 4 cases and patent in the remaining 23 cases, and the patency rate was 85.2%. Conclusion: Endovascular therapy as a safe and minimally invasive procedure can effectively deal with CS with concomitant DVT.


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引用

引用本文: 振振 李, 占祥 肖, 灼日 李, 昭凡 曾, 鸿飞 吴, 文波 张. Cockett综合征诱发下肢深静脉血栓形成的腔内治疗:附27例报告[J]. 中国普通外科杂志, 2016, 25(9): 1346-1350.
Cite this article as: LI Zhenzhen, XIAO Zhanxiang, LI Zhuori, ZENG Zhaofan, WU Hongfei, Zhang Wenbo . Endovascular therapy of deep venous thrombosis induced by Cockett's syndrome: a report of 27 cases [J]. Chin J Gen Surg, 2016, 25(9): 1346-1350.