Objective To summarize the clinical outcome of combined operation for patients with Cockett syndrome complicated with acute symptomatic deep venous thrombosis （DVT）.
Methods From October 2008 to March 2012， a total of 23 patients （male 8 cases and female 15 cases；mean age 59.3 years old， range 36-76 years old） with Cockett syndrome complicated with acute symptomatic DVT were underwent combined surgical venous thrombectomy and endovascular stenting in ipisilateral iliac vein in our hospital. All the patients were underwent duplex ultrasonography for diagnosis of DVT. The location of thrombosis in the left iliofemoral vein was 21 cases， right iliofemoral vein was 2 cases. The affected limb of all the patients were severely swell and pain. The mean time of symptomatic DVT occurring at operation was 2.53d. All the operations were performed under general anesthesia. The inferior vena cava filter was inserted before thrombectomy， iliac vein compression was diagnosed by angiography and treated with self-expandable stent after thrombectomy. Twenty-eight self-expandable stents were placed successfully.
Results In all the cases， the procedural successful rate was 100%， the 30-day mortality rate was 0. One case suffered from hematoma at incision after operation. Median follow-up was 11.7 months （range 3-26 months）. There was no case of rethrombosis. Symptoms were disappeared in 21 cases， the leg slightly swelled in 2 patients.
Conclusion Combined surgical thrombectomy and endovascular treatment for patients with Cockett syndrome complicated with acute symptomatic DVT is an effective and safe technique with low morbidity and good clinical results.
Citation：
CHEN Jie,YE Zhidong,FAN Xueqiang,LIU Peng,.. Analysis of Clinical Outcome of Combined Operation for Cockett Syndrome Complicated with Acute Deep Venous Thrombosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(11): 1175-1178. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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Kahn SR， Lamping DL， Ducruet T， et al. VEINES-QOL/Sym questionnaire was a reliable and valid disease-specific quality of life measure for deep venous thrombosis[J]. J Clin Epidemiol， 2006， 59(10)：1049-1056.
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Tuygun AK， Ketenci B， Günay R， et al. Validity and reliability of VEINES-QOL/Sym questionnaire in chronic venous disorders[J]. J Cardiovasc Surg (Torino)， 2012， 53(3)：355-361.
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Akesson H， Brudin L， Dahlström JA， et al. Venous function assessed during a 5 year period after acute ilio-femoral venous thrombosis treated with anticoagulation[J]. Eur J Vasc Surg， 1990， 4(1)：43-48.
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Comerota AJ， Throm RC， Mathias SD， et al. Catheter-directed thrombolysis for iliofemoral deep venous thrombosis improves health-related quality of life[J]. J Vasc Surg， 2000， 32(1)：130-137.
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Delis KT， Bountouroglou D， Mansfield AO. Venous claudication in iliofemoral thrombosis：long-term effects on venous hemodynamics， clinical status， and quality of life[J]. Ann Surg， 2004， 239(1)：118-126.
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赵军， 董国祥. 左髂总静脉狭窄与急性下肢深静脉血栓形成[J]. 中华外科杂志， 1998， 36(1)：12-14.
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Shebel ND， Whalen CC. Diagnosis and management of iliac vein compression syndrome[J]. J Vasc Nurs， 2005， 23(1)：10-19.
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Cho YP， Ahn JH， Choi SJ， et al. Endovascular management of iliofemoral deep venous thrombosis due to iliac vein compression syndrome in patients with protein C and/or S deficiency[J]. J Korean Med Sci， 2004， 19(5)：729-734.
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Berger A， Jaffe JW， York TN. Iliac compression syndrome treated with stent placement[J]. J Vasc Surg， 1995， 21(3)：510-514.
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Oguzkurt L， Tercan F， Ozkan U， et al. Iliac vein compression syndrome：outcome of endovascular treatment with long-term follow-up[J]. Eur J Radiol， 2008， 68(3)：487-492.
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Patel NH， Stookey KR， Ketcham DB， et al. Endovascular management of acute extensive iliofemoral deep venous thrombosis caused by May-Thurner syndrome[J]. J Vasc Interv Radiol， 2000， 11(10)：1297-1302.
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Raju S. Iliac vein outflow obstruction in ‘primary’ chronic venous disease[J]. Phlebolymphology， 2008， 15(1)：12-16.
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Raju S， Owen S Jr， Neglen P. The clinical impact of iliac venous stents in the management of chronic venous insufficiency[J]. J Vasc Surg， 2002， 35(1)：8-15.
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O’Sullivan GJ， Semba CP， Bittner CA， et al. Endovascular management of iliac vein compression (May-Thurner) syndrome[J]. J Vasc Interv Radiol， 2000， 11(7)：823-836.
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Mussa FF， Peden EK， Zhou W， et al. Iliac vein stenting for chronic venous insufficiency[J]. Tex Heart Inst J， 2007， 34(1)：60-66.
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Forauer AR， Gemmete JJ， Dasika NL， et al. Intravascular ultrasound in the diagnosis and treatment of iliac vein compression (May-Thurner) syndrome[J]. J Vasc Interv Radiol， 2002， 13(5)：523-527.
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Neglén P， Raju S. Balloon dilation and stenting of chronic iliac vein obstruction：technical aspects and early clinical outcome[J]. J Endovasc Ther， 2000， 7(2)：79-91.
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Neglén P， Raju S. Intravascular ultrasound scan evaluation of the obstructed vein[J]. J Vasc Surg， 2002， 35(4)：694-700.
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Lumsden AB， Macdonald MJ， Isiklar H， et al. Central venous stenosis in the hemodialysis patient：incidence and efficacy of endovascular treatment[J]. Cardiovasc Surg， 1997， 5(5)：504-509.
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- 1. Cockett FB， Thomas ML. The iliac compression syndrome[J]. Br J Surg， 1965， 52(10)：816-821.
- 2. Kahn SR， Lamping DL， Ducruet T， et al. VEINES-QOL/Sym questionnaire was a reliable and valid disease-specific quality of life measure for deep venous thrombosis[J]. J Clin Epidemiol， 2006， 59(10)：1049-1056.
- 3. Tuygun AK， Ketenci B， Günay R， et al. Validity and reliability of VEINES-QOL/Sym questionnaire in chronic venous disorders[J]. J Cardiovasc Surg (Torino)， 2012， 53(3)：355-361.
- 4. Akesson H， Brudin L， Dahlström JA， et al. Venous function assessed during a 5 year period after acute ilio-femoral venous thrombosis treated with anticoagulation[J]. Eur J Vasc Surg， 1990， 4(1)：43-48.
- 5. Comerota AJ， Throm RC， Mathias SD， et al. Catheter-directed thrombolysis for iliofemoral deep venous thrombosis improves health-related quality of life[J]. J Vasc Surg， 2000， 32(1)：130-137.
- 6. Delis KT， Bountouroglou D， Mansfield AO. Venous claudication in iliofemoral thrombosis：long-term effects on venous hemodynamics， clinical status， and quality of life[J]. Ann Surg， 2004， 239(1)：118-126.
- 7. 赵军， 董国祥. 左髂总静脉狭窄与急性下肢深静脉血栓形成[J]. 中华外科杂志， 1998， 36(1)：12-14.
- 8. 张精勇， 金星， 吴学君， 等. 滤器保护下置管溶栓治疗下肢深静脉血栓形成临床总结[J]. 中国实用外科杂志， 2006， 26(10)：774-776.
- 9. Shebel ND， Whalen CC. Diagnosis and management of iliac vein compression syndrome[J]. J Vasc Nurs， 2005， 23(1)：10-19.
- 10. Cho YP， Ahn JH， Choi SJ， et al. Endovascular management of iliofemoral deep venous thrombosis due to iliac vein compression syndrome in patients with protein C and/or S deficiency[J]. J Korean Med Sci， 2004， 19(5)：729-734.
- 11. Berger A， Jaffe JW， York TN. Iliac compression syndrome treated with stent placement[J]. J Vasc Surg， 1995， 21(3)：510-514.
- 12. Oguzkurt L， Tercan F， Ozkan U， et al. Iliac vein compression syndrome：outcome of endovascular treatment with long-term follow-up[J]. Eur J Radiol， 2008， 68(3)：487-492.
- 13. Patel NH， Stookey KR， Ketcham DB， et al. Endovascular management of acute extensive iliofemoral deep venous thrombosis caused by May-Thurner syndrome[J]. J Vasc Interv Radiol， 2000， 11(10)：1297-1302.
- 14. Raju S. Iliac vein outflow obstruction in ‘primary’ chronic venous disease[J]. Phlebolymphology， 2008， 15(1)：12-16.
- 15. Raju S， Owen S Jr， Neglen P. The clinical impact of iliac venous stents in the management of chronic venous insufficiency[J]. J Vasc Surg， 2002， 35(1)：8-15.
- 16. O’Sullivan GJ， Semba CP， Bittner CA， et al. Endovascular management of iliac vein compression (May-Thurner) syndrome[J]. J Vasc Interv Radiol， 2000， 11(7)：823-836.
- 17. Mussa FF， Peden EK， Zhou W， et al. Iliac vein stenting for chronic venous insufficiency[J]. Tex Heart Inst J， 2007， 34(1)：60-66.
- 18. Forauer AR， Gemmete JJ， Dasika NL， et al. Intravascular ultrasound in the diagnosis and treatment of iliac vein compression (May-Thurner) syndrome[J]. J Vasc Interv Radiol， 2002， 13(5)：523-527.
- 19. Neglén P， Raju S. Balloon dilation and stenting of chronic iliac vein obstruction：technical aspects and early clinical outcome[J]. J Endovasc Ther， 2000， 7(2)：79-91.
- 20. Neglén P， Raju S. Intravascular ultrasound scan evaluation of the obstructed vein[J]. J Vasc Surg， 2002， 35(4)：694-700.
- 21. Lumsden AB， Macdonald MJ， Isiklar H， et al. Central venous stenosis in the hemodialysis patient：incidence and efficacy of endovascular treatment[J]. Cardiovasc Surg， 1997， 5(5)：504-509.
- 22. Neglén P， Tackett TP Jr， Raju S. Venous stenting across the inguinal ligament[J]. J Vasc Surg， 2008， 48(5)：1255-1261.
