RESUMO
Objective: To evaluate the safety and efficacy of one-stop treatment (iliac vein stenting and varicose vein surgery) for Cockett syndrome combined with varicose veins of lower limbs. Methods: There were 58 cases diagnosed as Cockett syndrome combined with varicose veins of lower limbs underwent one-stop treatment. The postoperative complications and with or without varicose veins recurrence were observed, venous clinical severity score (VCSS), Aberdeen varicose vein questionnaire (AVVQ) score and iliac vein stent patency rate of preoperative and postoperative followed up 1, 3, 6 and 12 months were recorded. Results: All the 58 patients underwent one-stop treatment successfully, and the technical success rate was 100%; 3 patients with active ulcer healed completely within 1 month after operation; there were no severe complications such as deep vein thrombosis and pulmonary embolism occurred. The VCSS and AVVQ scores at 1, 3, 6 and 12 months after operation were significantly lower than those of before surgery (all P<0.001). At 12 months follow-up, the patency rate of iliac vein stent was 100%, and there were no recurrence of varicose veins in lower limbs. Conclusion: The one-stop treatment for Cockett syndrome combined with varicose veins of lower limbs has good safety and effectiveness, and the short-term iliac vein stent patency rate is satisfactory, which has a certain promotion significance.
RESUMO
Objective To evaluate treatment outcomes in patients with Cockett syndrome complicating acute lower extremity deep vein thrombosis (DVT) either by direct stenting after taking angioplasty followed by catheter-directed thrombolysis or staged stenting after taking angioplasty and catheterdirected thrombolysis with urokinase.Methods From Jun 2015 to Jun 2017,35 Cockett syndrome patients with DVT were divided into group A (direct stenting after taking angioplasty followed by catheterdirected thrombolysis,n =15) and group B (staged stenting after taking angioplasty and catheter-directed thrombolysis with urokinase,n =20).The total urokinase dosage,the time of thrombolysis,and the score of thrombolysis rate were evaluated.After six months of follow-up,the difference between two groups of limb circumference,patency rate and PTS rate were compared.Results The technical success rate in both group was 100％.There was no fatal pulmonary embolism and massive bleeding during the perioperative period.During treatment,both groups showed significant improvement in limb swelling compared with that before operation.The differences in the total used dosages of urokinase and thrombolysis time were not statistically significant (P =0.47,P =0.51 respectively).Thrombolysis rates above grade Ⅱ in group A and group B were 93.33％ and 90％ (P =0.64),but stent placement was not satisfactory in 2 cases in group A.After six months of follow-up,there was no significant difference between two groups of limb circumference and PTS rate,but patency rate of the two groups was 85.2％ ± 2.4％ and 87.6％ ± 1.8％ respectively (P =0.02).Conclusions For the treatment of Cockett syndrome with DVT,the timing of stent implantation does not affect thrombolytic treatment process.However,the complete removal of the iliac vein thrombosis is beneficial to precise release of the stent and the stent implantation can better maintain iliac vein lumen patency.