与支架困难相关的因素 慢性 iliofemoral 静脉阻塞
Moustafa Elfeky1, Mohammad E Barbati1, Karina Schleimer1
1Department of Vascular and Endovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany.
概括
对于慢性静脉阻塞而言,内血管再通道治疗很少失败. 重复干预严重的支架变形的成功率很低,但对于敌对的小腿或之前的手术,成功率接近50%.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 心血管医学 心血管医学
背景情况:
- 血栓后综合征与堵塞的阴茎静脉对内血管再通道化提出了复杂的挑战.
- 在这些程序中出现的技术故障可能会对患者的治疗结果产生重大影响.
研究的目的:
- 调查慢性 iliofemoral静脉阻塞的内血管再通道技术故障的原因.
- 在具有挑战性的案例中,确定替代技术并改善结果.
主要方法:
- 在2015年11月至2020年8月期间接受治疗的230名患有症状慢性 iliofemoral静脉阻塞的患者 (274个四肢) 的回顾性分析.
- 评估初始内血管再通道试验,重点关注初始失败的15个案例和随后的干预.
主要成果:
- 最初的内血管再通道在5.4%的四肢中失败了,这归因于诸如静脉注射药物使用者的"敌对沟" (6例),之前的手术 (5例),严重的支架形 (3例) 和先天性静脉形 (1例) 等因素.
- 在最初失败的15名患者中,有11人接受了再干预,在6例病例中成功实现了再道化 (54.5%的再干预成功率).
- 成功的再干预表明了高的穿透率:初级 (83.3%),辅助初级 (100%) 和二级 (100%),平均随访27个月.
结论:
- 在慢性静脉阻塞中,再通道失败并不常见.
- 严重的支架变形是成功进行二次干预的可能性最低的.
- 对患有"敌对的沟"或先前在闭塞部位进行开放性手术的患者进行重新干预,成功率接近50%.
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