Percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis: clinical results of 18 cases_West China Medical Journal

Authors：

 ZHANG Xiquan , GE Shitang

Endovascular Interventional Diagnosis and Treatment Center, the 148th Hospital of Chinese People’s Liberation Army, Zibo, Shandong 255300, P. R. China;

Corresponding?author：

ZHANG Xiquan, Email: jrkzxq@163.com

Keywords：

Iliofemoral vein; Venous thrombosis; Interventional therapy

DOI：

10.7507/1002-0179.201610173

Video：

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Objective To investigate the clinical effect of percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis. Methods From November 2012 to February 2016, the clinical data of 18 patients with bilateral iliofemoral venous thrombosis were retrospectively analyzed. All patients including 7 males and 11 females, aged from 51 to 86 years with an average of (66.2±7.8) years old. All patients underwent interventional treatment, and mechanical aspiration thrombectomy was performed under the protection of inferior vena cava filter at the acute or subacute phase; those whose venography showed iliac vein stenosis received balloon dilatation and self-expandable stents immediately. Iliac vein stenosis received balloon dilatation and self-expandable stents immediately at the chronic phase. Results The treatment was successful in all patients. The circumference difference of thigh and calf was (7.3±2.1) and (4.6±2.7) cm respectively before and after treatment. Thirteen patients with stenosis or occlusion of the iliac vein were treated with adjunctive balloon dilatation and stent placement, and 20 self-expandable stents were inserted successfully. All the patients were followed up for 12–34 months with an average of (21.5±7.3) months; stenosis or occlusion of the stent were seen in 1 patient after 9 months; post thrombotic syndrome was observed in 1 patient after 12 months. The 12-month primary patency rate and secondary patency rate was 88.9% (16/18) and 100.0% (18/18), respectively. Conclusion Endovascular interventional therapy of bilateral iliofemoral venous thrombosis is a safe and effective method.

Citation： ZHANG Xiquan, GE Shitang. Percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis: clinical results of 18 cases. West China Medical Journal, 2017, 32(8): 1229-1232. doi: 10.7507/1002-0179.201610173 Copy

1.	趙俊來, 趙克強, 曹戰江, 等. 機械血栓清除術治療急性下肢靜脈血栓形成的療效分析. 中華醫學雜志, 2015, 95(48): 3917-3919.
2.	Grommes J, Strijkers R, Greiner A, et al. Safety and feasibility of ultrasound-accelerated catheter directed thrombolysis in deep vein thrombosis. Eur J Vasc Endovasc Surg, 2011, 41(4): 526-532.
3.	中華醫學會外科學分會血管外科學組. 深靜脈血栓形成的診斷和治療指南(第 2 版). 中華外科雜志, 2012, 50(7): 611-614.
4.	Meissner MH, Gloviczki P, Comerota AJ, et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for vascular Surgery and the American Venous Forum. J Vasc Surg, 2012, 55 (5): 1449-1462.
5.	Yamaki T, Hamahata A, Soejima K, et al. Factors predicting development of post-thrombotic syndrome in patients with a first episode of deep vein thrombosis: preliminary report. Eur J Vasc Endovasc Surg, 2011, 41(1): 126-133.
6.	虞曉龍, 李尊, 鄭建剛, 等. 彩色多普勒超聲診斷下肢深靜脈血栓. 中國醫學影像技術, 2013, 29(1): 51-54.
7.	金云芳, 俞揚, 何琪芳, 等. 彩色多普勒超聲診斷下肢深靜脈血栓形成與相關危險因素的分析. 醫學影像學雜志, 2015, 25(8): 1506-1509.
8.	Gaitini D. Multimodality imaging of the peripheral venous system. Int J Biomed Imaging, 2007, 2007: 54616.
9.	Wille-J?rgensen P, Borris L, J?rgensen LN, et al. Phlebography as the gold standard in thrombo prophylactic studies. Acta radiol, 2010, 33(1): 24-28.
10.	Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e419S-e494S.
11.	Guyatt GH, Norris SL, Schulman S, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): 53S-70S.
12.	李文東, 李曉強, 錢愛民, 等. 下肢深靜脈血栓形成治療進展. 中國實用外科雜志, 2014, 34(12): 1190-1193.
13.	Haig Y, Enden T, Slagsvold CE, et al. Residual rates of reflux and obstruction and their correlation to post-thrombotic syndrome in a randomized study on catheter-directed thrombolysis for deep vein thrombosis. J Vasc Surg: Venous and Lym Dis, 2014, 2(2): 123-130.
14.	O?uzkurt L, Ozkan U, Gülcan O, et al. Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis by using manual aspiration thrombectomy: long-term results of 139 patients in a single center. Diagn Interv Radiol, 2012, 18(4): 410-416.
15.	Kwak HS, Han YM, Lee YS, et al. Stents in common iliac vein obstruction with acute ipsilateral deep venous thrombosis: early and late results. J Vasc Interv Radiol, 2005, 16(6): 815-822.
16.	李曉強, 于小濱. 導管接觸性溶栓在急性下肢深靜脈血栓形成治療中的相關問題再探討. 中國血管外科雜志: 電子版, 2014, 6(1): 9-11.
17.	李曉強, 孟慶友, 姜坤, 等. 下肢深靜脈血栓形成導管溶栓術后髂靜脈病變支架治療的前瞻性對照性研究. 中國血管外科雜志: 電子版, 2012, 4(1): 13-15, 19.
18.	王子軍, 武國棟, 趙金超, 等. 主髂動脈硬化閉塞癥的腔內治療. 中國普通外科雜志, 2012, 21(6): 758-759.
19.	葛世堂, 任美健, 張希全, 等. 介入手術治療復雜主髂動脈閉塞癥: 附 16 例分析. 中國普通外科雜志, 2016, 25(6): 848-852.
20.	趙紀春, 吳洲鵬. 靜脈血栓栓塞癥治療進展. 中國實用外科雜志, 2015, 35(12): 1348-1351.

1. 趙俊來, 趙克強, 曹戰江, 等. 機械血栓清除術治療急性下肢靜脈血栓形成的療效分析. 中華醫學雜志, 2015, 95(48): 3917-3919.
2. Grommes J, Strijkers R, Greiner A, et al. Safety and feasibility of ultrasound-accelerated catheter directed thrombolysis in deep vein thrombosis. Eur J Vasc Endovasc Surg, 2011, 41(4): 526-532.
3. 中華醫學會外科學分會血管外科學組. 深靜脈血栓形成的診斷和治療指南(第 2 版). 中華外科雜志, 2012, 50(7): 611-614.
4. Meissner MH, Gloviczki P, Comerota AJ, et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for vascular Surgery and the American Venous Forum. J Vasc Surg, 2012, 55 (5): 1449-1462.
5. Yamaki T, Hamahata A, Soejima K, et al. Factors predicting development of post-thrombotic syndrome in patients with a first episode of deep vein thrombosis: preliminary report. Eur J Vasc Endovasc Surg, 2011, 41(1): 126-133.
6. 虞曉龍, 李尊, 鄭建剛, 等. 彩色多普勒超聲診斷下肢深靜脈血栓. 中國醫學影像技術, 2013, 29(1): 51-54.
7. 金云芳, 俞揚, 何琪芳, 等. 彩色多普勒超聲診斷下肢深靜脈血栓形成與相關危險因素的分析. 醫學影像學雜志, 2015, 25(8): 1506-1509.
8. Gaitini D. Multimodality imaging of the peripheral venous system. Int J Biomed Imaging, 2007, 2007: 54616.
9. Wille-J?rgensen P, Borris L, J?rgensen LN, et al. Phlebography as the gold standard in thrombo prophylactic studies. Acta radiol, 2010, 33(1): 24-28.
10. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e419S-e494S.
11. Guyatt GH, Norris SL, Schulman S, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): 53S-70S.
12. 李文東, 李曉強, 錢愛民, 等. 下肢深靜脈血栓形成治療進展. 中國實用外科雜志, 2014, 34(12): 1190-1193.
13. Haig Y, Enden T, Slagsvold CE, et al. Residual rates of reflux and obstruction and their correlation to post-thrombotic syndrome in a randomized study on catheter-directed thrombolysis for deep vein thrombosis. J Vasc Surg: Venous and Lym Dis, 2014, 2(2): 123-130.
14. O?uzkurt L, Ozkan U, Gülcan O, et al. Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis by using manual aspiration thrombectomy: long-term results of 139 patients in a single center. Diagn Interv Radiol, 2012, 18(4): 410-416.
15. Kwak HS, Han YM, Lee YS, et al. Stents in common iliac vein obstruction with acute ipsilateral deep venous thrombosis: early and late results. J Vasc Interv Radiol, 2005, 16(6): 815-822.
16. 李曉強, 于小濱. 導管接觸性溶栓在急性下肢深靜脈血栓形成治療中的相關問題再探討. 中國血管外科雜志: 電子版, 2014, 6(1): 9-11.
17. 李曉強, 孟慶友, 姜坤, 等. 下肢深靜脈血栓形成導管溶栓術后髂靜脈病變支架治療的前瞻性對照性研究. 中國血管外科雜志: 電子版, 2012, 4(1): 13-15, 19.
18. 王子軍, 武國棟, 趙金超, 等. 主髂動脈硬化閉塞癥的腔內治療. 中國普通外科雜志, 2012, 21(6): 758-759.
19. 葛世堂, 任美健, 張希全, 等. 介入手術治療復雜主髂動脈閉塞癥: 附 16 例分析. 中國普通外科雜志, 2016, 25(6): 848-852.
20. 趙紀春, 吳洲鵬. 靜脈血栓栓塞癥治療進展. 中國實用外科雜志, 2015, 35(12): 1348-1351.

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Percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis: clinical results of 18 cases

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