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Objective:To evaluate the technical aspects and examine patency rates of stent placement across the inguinal ligament for managing long-segment iliac venous obstruction.Methods:From Jan 2012 to Jan 2017, a total of 73 patients (42 cases of post-acute deep venous thrombosis(DVT) thrombolysis and 31 of post-thrombotic syndrome (PTS)) with long-segment iliac venous obstruction were treated with interventional surgery. All patients underwent balloon dilatation and placement of at least two stents extending below inguinal ligament.Results:The technical success rate was 100%. No serious perioperative complications occurred. The mean duration of the procedure in the DVT group was shorter than PTS group(35±12) min vs. (62±12) min, P<0.05). The mean number of stents did not differ between the two groups.Mean follow up periods was 28.34 months. Overall cumulative primary, assisted primary, and secondary stent patency rates were 100%, 100%, and 100% at 6 months and 87.7%, 95.9%, and 100% at 12 months and 75.8%, 85.1%, and 96.3% at 24 months, respectively(all P>0.05). Edema and pain alleviated significantly in the two groups. There was no stents compressed or fractured. Conclusions:Stenting across the inguinal ligament for treatment of long-segment iliac venous obstruction is a safe, effective, and feasible method.
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Objective To evaluate pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated by Cockett syndrome in the left lower limbs.Method Data of 137 cases of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb by interventional therapy from January 2007 to October 2012 were analyzed retrospectively.Inferior vena cava filters were placed in all of the patients.Patients were divided into two groups:Group A (n =81) treated with catheter directed thrombolysis only,Group B (n =56) treated with pigtail catheter mashing thrombosis combined with catheter directed thrombolysis.After operation,patients were treated by anticoagulation with urokinase and heparin calcium,and then warfarin for 6 to 1 2 months.Results The thrombolysis time in group B was significantly shorter than that in group A (P ＜0.01),the dosage of urokinase was significantly less than that in group A(P ＜ 0.01).The venous patency score in group B after therapy was significantly better than in group A (P ＜ 0.01).121 patients were followed up for 10-60 months.There were no pulmonary embolism.Conclusions Pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb can improve thrombolytic efficiency,shorten thrombolysis time,reduce the use of urokinase.
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Objective To explore the treatment of thromboangitis obliterans (TAO) of lower extremities.Methods From March 1994 to February 2009,24 cases (26 limbs) affected by chronic ischemia were diagnosed as TAO by Doppler ultrasound and DSA,CTA or MRA.According to the different levels of the extensive and diffuse arterial occlusion,the revascularization was performed in the ways:19 cases (21 limbs) underwent venous arterialization,3 cases (3 limbs) underwent endovascular therapy,and 2 cases (2 limbs) underwent thrombectomy.ResultsAfter the venous arterialization,19 cases (21 limbs) were followed up for 1 to 14.5 years.Apart from the 5 limbs amputation (23.8%),the postoperative results of the most limbs were satisfactory (61.9%).The ABI before therapy (0.38?0.11) was significantly lower than that 6 months after therapy (0.79?0.08),P
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ObjectiveTo study the treament of arterial occlusion of lower extrimities. MethodsSeventy-three cases(78 limbs) of chronic ischemia o f lower extremities were diagnosed as artroial occlusion by color u ltrasounography, DSA or MRA. Arterial bypass using grafting,endarterectomy and percuteneous transluminal angioplasty (PTA) were used for the artery segmental occlusion in 44 limbs. Venous arterialization and reconstruc tion of profunda femoris were performed for extensive occlusion in 29 limbs. ResultsAll the cases showed satisfactory r esults 6 months to 8 years after operation except 8 limbs (segmenta l occlusion in 3 limbs and extensive occlusion in 5 limbs) were amputated. ConclusionsThe key points of improvement of the therapeu tic effects of the arteral occlusion of lowe extremity lie on the cho ice of the therapeutic methods accoding to the results of DSA or MRA.