Percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis: clinical results of 18 cases_West China Medical Journal

Authors：

 ZHANG Xiquan , GE Shitang

Endovascular Interventional Diagnosis and Treatment Center, the 148th Hospital of Chinese People’s Liberation Army, Zibo, Shandong 255300, P. R. China;

Corresponding author：

ZHANG Xiquan, Email: jrkzxq@163.com

Keywords：

Iliofemoral vein; Venous thrombosis; Interventional therapy

DOI：

10.7507/1002-0179.201610173

Video：

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Objective To investigate the clinical effect of percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis. Methods From November 2012 to February 2016, the clinical data of 18 patients with bilateral iliofemoral venous thrombosis were retrospectively analyzed. All patients including 7 males and 11 females, aged from 51 to 86 years with an average of (66.2±7.8) years old. All patients underwent interventional treatment, and mechanical aspiration thrombectomy was performed under the protection of inferior vena cava filter at the acute or subacute phase; those whose venography showed iliac vein stenosis received balloon dilatation and self-expandable stents immediately. Iliac vein stenosis received balloon dilatation and self-expandable stents immediately at the chronic phase. Results The treatment was successful in all patients. The circumference difference of thigh and calf was (7.3±2.1) and (4.6±2.7) cm respectively before and after treatment. Thirteen patients with stenosis or occlusion of the iliac vein were treated with adjunctive balloon dilatation and stent placement, and 20 self-expandable stents were inserted successfully. All the patients were followed up for 12–34 months with an average of (21.5±7.3) months; stenosis or occlusion of the stent were seen in 1 patient after 9 months; post thrombotic syndrome was observed in 1 patient after 12 months. The 12-month primary patency rate and secondary patency rate was 88.9% (16/18) and 100.0% (18/18), respectively. Conclusion Endovascular interventional therapy of bilateral iliofemoral venous thrombosis is a safe and effective method.

Citation： ZHANG Xiquan, GE Shitang. Percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis: clinical results of 18 cases. West China Medical Journal, 2017, 32(8): 1229-1232. doi: 10.7507/1002-0179.201610173 Copy

1.	赵俊来, 赵克强, 曹战江, 等. 机械血栓清除术治疗急性下肢静脉血栓形成的疗效分析. 中华医学杂志, 2015, 95(48): 3917-3919.
2.	Grommes J, Strijkers R, Greiner A, et al. Safety and feasibility of ultrasound-accelerated catheter directed thrombolysis in deep vein thrombosis. Eur J Vasc Endovasc Surg, 2011, 41(4): 526-532.
3.	中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第 2 版). 中华外科杂志, 2012, 50(7): 611-614.
4.	Meissner MH, Gloviczki P, Comerota AJ, et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for vascular Surgery and the American Venous Forum. J Vasc Surg, 2012, 55 (5): 1449-1462.
5.	Yamaki T, Hamahata A, Soejima K, et al. Factors predicting development of post-thrombotic syndrome in patients with a first episode of deep vein thrombosis: preliminary report. Eur J Vasc Endovasc Surg, 2011, 41(1): 126-133.
6.	虞晓龙, 李尊, 郑建刚, 等. 彩色多普勒超声诊断下肢深静脉血栓. 中国医学影像技术, 2013, 29(1): 51-54.
7.	金云芳, 俞扬, 何琪芳, 等. 彩色多普勒超声诊断下肢深静脉血栓形成与相关危险因素的分析. 医学影像学杂志, 2015, 25(8): 1506-1509.
8.	Gaitini D. Multimodality imaging of the peripheral venous system. Int J Biomed Imaging, 2007, 2007: 54616.
9.	Wille-Jørgensen P, Borris L, Jørgensen LN, et al. Phlebography as the gold standard in thrombo prophylactic studies. Acta radiol, 2010, 33(1): 24-28.
10.	Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e419S-e494S.
11.	Guyatt GH, Norris SL, Schulman S, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): 53S-70S.
12.	李文东, 李晓强, 钱爱民, 等. 下肢深静脉血栓形成治疗进展. 中国实用外科杂志, 2014, 34(12): 1190-1193.
13.	Haig Y, Enden T, Slagsvold CE, et al. Residual rates of reflux and obstruction and their correlation to post-thrombotic syndrome in a randomized study on catheter-directed thrombolysis for deep vein thrombosis. J Vasc Surg: Venous and Lym Dis, 2014, 2(2): 123-130.
14.	Oğuzkurt L, Ozkan U, Gülcan O, et al. Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis by using manual aspiration thrombectomy: long-term results of 139 patients in a single center. Diagn Interv Radiol, 2012, 18(4): 410-416.
15.	Kwak HS, Han YM, Lee YS, et al. Stents in common iliac vein obstruction with acute ipsilateral deep venous thrombosis: early and late results. J Vasc Interv Radiol, 2005, 16(6): 815-822.
16.	李晓强, 于小滨. 导管接触性溶栓在急性下肢深静脉血栓形成治疗中的相关问题再探讨. 中国血管外科杂志: 电子版, 2014, 6(1): 9-11.
17.	李晓强, 孟庆友, 姜坤, 等. 下肢深静脉血栓形成导管溶栓术后髂静脉病变支架治疗的前瞻性对照性研究. 中国血管外科杂志: 电子版, 2012, 4(1): 13-15, 19.
18.	王子军, 武国栋, 赵金超, 等. 主髂动脉硬化闭塞症的腔内治疗. 中国普通外科杂志, 2012, 21(6): 758-759.
19.	葛世堂, 任美健, 张希全, 等. 介入手术治疗复杂主髂动脉闭塞症: 附 16 例分析. 中国普通外科杂志, 2016, 25(6): 848-852.
20.	赵纪春, 吴洲鹏. 静脉血栓栓塞症治疗进展. 中国实用外科杂志, 2015, 35(12): 1348-1351.

1. 赵俊来, 赵克强, 曹战江, 等. 机械血栓清除术治疗急性下肢静脉血栓形成的疗效分析. 中华医学杂志, 2015, 95(48): 3917-3919.
2. Grommes J, Strijkers R, Greiner A, et al. Safety and feasibility of ultrasound-accelerated catheter directed thrombolysis in deep vein thrombosis. Eur J Vasc Endovasc Surg, 2011, 41(4): 526-532.
3. 中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第 2 版). 中华外科杂志, 2012, 50(7): 611-614.
4. Meissner MH, Gloviczki P, Comerota AJ, et al. Early thrombus removal strategies for acute deep venous thrombosis: clinical practice guidelines of the Society for vascular Surgery and the American Venous Forum. J Vasc Surg, 2012, 55 (5): 1449-1462.
5. Yamaki T, Hamahata A, Soejima K, et al. Factors predicting development of post-thrombotic syndrome in patients with a first episode of deep vein thrombosis: preliminary report. Eur J Vasc Endovasc Surg, 2011, 41(1): 126-133.
6. 虞晓龙, 李尊, 郑建刚, 等. 彩色多普勒超声诊断下肢深静脉血栓. 中国医学影像技术, 2013, 29(1): 51-54.
7. 金云芳, 俞扬, 何琪芳, 等. 彩色多普勒超声诊断下肢深静脉血栓形成与相关危险因素的分析. 医学影像学杂志, 2015, 25(8): 1506-1509.
8. Gaitini D. Multimodality imaging of the peripheral venous system. Int J Biomed Imaging, 2007, 2007: 54616.
9. Wille-Jørgensen P, Borris L, Jørgensen LN, et al. Phlebography as the gold standard in thrombo prophylactic studies. Acta radiol, 2010, 33(1): 24-28.
10. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): e419S-e494S.
11. Guyatt GH, Norris SL, Schulman S, et al. Methodology for the development of antithrombotic therapy and prevention of thrombosis guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(2 Suppl): 53S-70S.
12. 李文东, 李晓强, 钱爱民, 等. 下肢深静脉血栓形成治疗进展. 中国实用外科杂志, 2014, 34(12): 1190-1193.
13. Haig Y, Enden T, Slagsvold CE, et al. Residual rates of reflux and obstruction and their correlation to post-thrombotic syndrome in a randomized study on catheter-directed thrombolysis for deep vein thrombosis. J Vasc Surg: Venous and Lym Dis, 2014, 2(2): 123-130.
14. Oğuzkurt L, Ozkan U, Gülcan O, et al. Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis by using manual aspiration thrombectomy: long-term results of 139 patients in a single center. Diagn Interv Radiol, 2012, 18(4): 410-416.
15. Kwak HS, Han YM, Lee YS, et al. Stents in common iliac vein obstruction with acute ipsilateral deep venous thrombosis: early and late results. J Vasc Interv Radiol, 2005, 16(6): 815-822.
16. 李晓强, 于小滨. 导管接触性溶栓在急性下肢深静脉血栓形成治疗中的相关问题再探讨. 中国血管外科杂志: 电子版, 2014, 6(1): 9-11.
17. 李晓强, 孟庆友, 姜坤, 等. 下肢深静脉血栓形成导管溶栓术后髂静脉病变支架治疗的前瞻性对照性研究. 中国血管外科杂志: 电子版, 2012, 4(1): 13-15, 19.
18. 王子军, 武国栋, 赵金超, 等. 主髂动脉硬化闭塞症的腔内治疗. 中国普通外科杂志, 2012, 21(6): 758-759.
19. 葛世堂, 任美健, 张希全, 等. 介入手术治疗复杂主髂动脉闭塞症: 附 16 例分析. 中国普通外科杂志, 2016, 25(6): 848-852.
20. 赵纪春, 吴洲鹏. 静脉血栓栓塞症治疗进展. 中国实用外科杂志, 2015, 35(12): 1348-1351.

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Percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis: clinical results of 18 cases

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