Résumé
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.
Résumé
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.