对于静脉胸部外出综合征的第一个肋骨切除过程中完成手术内静脉扫描的分析
Brandon A Creisher1, Julian Jackson1, Simona Sica2
1Division of Vascular and Endovascular Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
在第一个肋骨切除后完成手术内静脉扫描,以治疗轴关节静脉血栓症,可提供出色的症状缓解和通透性. 这种方法支持静脉胸部出口综合征的保守管理,即使有残留狭窄或闭塞.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 胸部外科手术 胸部外科手术
背景情况:
- 轴下关节静脉 (AxSCV) 血栓是静脉胸腔出口综合征 (vTOS) 的并发症.
- 第一个肋骨切除 (FRR) 是对vTOS的主要治疗方法.
- 完成手术内静脉扫描在FRR后管理AxSCV血栓的作用需要评估.
研究的目的:
- 评估完成手术内静脉造影对由于vTOS导致AxSCV血栓形成的患者临床结果的影响.
- 为了将静脉检查结果与FRR后患者的结果相关联.
主要方法:
- 用FRR和手术内静脉学 (2011-2023) 治疗的vTOS患者的回顾性审查.
- 术内静脉检查发现的分类 (狭窄,闭塞).
- 评估症状缓解,3个月和1年的初级通透性,再干预率和并发症.
主要成果:
- 49名患者中的51名AxSCV接受了FRR和静脉学治疗.
- 在68.7%的病例中,完整静脉扫描显示了不同程度的狭窄或闭塞.
- 整体症状缓解为86.3%,3个月和1年的初级通透率分别为97.7%和97.0%.
- 静脉学分类与不良结果没有相关性.
结论:
- 结合FRR和完整的手术内静脉扫描,为AxSCV血栓形成提供了优异的症状缓解和短期到中期的通透性.
- 完成静脉扫描的发现,包括残留狭窄或闭塞,并没有对结果产生不利影响.
- 本协议支持在FRR后发现的AxSCV封闭的保守管理方法.
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