Cockett综合征的腔内介入治疗疗效分析

Efficacy analysis of endovascular interventional therapy of Cockett syndrome

关键词:  Cockett综合征  腔内治疗  下肢深静脉血栓形成  溶栓  支架

Key words:  Cockett syndrome  endovascular treatment  deep vein thrombosis  thrombolysis  stent

摘要:

目的　评估腔内介入治疗Cockett综合征的疗效。方法　回顾性分析53例Cockett综合征患者（女性49例，男性4例）的临床资料。41例患者表现为急性或亚急性下肢深静脉血栓形成，予以导管引导下溶栓+球囊扩张+支架植入术；12例患者表现为慢性静脉高压，予以球囊扩张+支架植入术。术后随访时间6~36个月，平均随访时间（21±15）个月。术后1个月、6个月及以后每年进行一次临床和造影评估。结果　术后所有患者左髂静脉均完全畅通，41例深静脉血栓形成患者中37例(90.2%)患者血栓完全溶解。在术后随访中，49例患者(92.5%)症状完全缓解，4例患者症状明显缓解(7.5%)，50例患者(94.3%)支架完全畅通，3例患者(5.7%)出现了支架再狭窄。无死亡患者。结论　腔内介入治疗Cockett综合征可明显缓解患者症状，具有较高的早-中期通畅率，且安全有效。

Abstract:

Objective　To evaluate the utility of treatment using endovascular techniques for Cockett syndrome. Methods　We retrospectively analyzed data on 53 MTS patients (49 females, 2 males). 41 patients, who presented with acute or subacute deep vein thrombosis (DVT), were treated with catheter-directed thrombolysis, followed by balloon dilatation and stent placement. 12 patients with symptoms associated with chronic venous hypertension (CVH) were treated with balloon dilatation and stent placement. The clinical and radiological follow-up time was 6 months,with anaverage follow-up time of (21±15) months. A clinical and angiographic assessment was performed in all patients at 1 months, 6 months, and later in the year. Results　Complete left common iliac vein patency was achieved in all patients. Complete thrombolysis was attained in 37 of the 41 DVT patients (90.2%). Upon follow-up, complete symptomatic regression was observed in 49 of the 53 patients (92.5%),and incomplete symptomatic regression in 4 patients(7.5%). Stent patency was complete in 50 of the 53 patients (94.3%) who received stents. Restenosis occurred in 3 patients(5.7%). No treatment-related mortality was observed. Conclusion　Endovascular treatment of Cockett syndrome reduces symptoms in most patients, and is associated with high medium-term patency rates, which proves to be safe and effective.