[1]杜端明,邹英华①,刘鹏程,等.恶性腔静脉梗阻的介入综合治疗[J].中国微创外科杂志,2007,07(7):604-606.
　Du Duanming*,Zou Yinghua,Liu Pengcheng*,et al.Combined interventional therapy for malignant vena cava obstruction[J].Chinese Journal of Minimally Invasive Surgery,2007,07(7):604-606.
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恶性腔静脉梗阻的介入综合治疗()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年7期
页码:
604-606
栏目:
出版日期:
2007-07-20

文章信息/Info

Title:
Combined interventional therapy for malignant vena cava obstruction
作者:
杜端明; 邹英华①; 刘鹏程; 王超①; 余宏建; 陈在中
北京大学深圳医院影像中心，深圳518036
Author(s):
Du Duanming*;  Zou Yinghua;  Liu Pengcheng*;  et al.
*Radiology Department, Peking University Shenzhen Hospital, Shenzhen 518036, China
关键词:
腔静脉梗阻; 支架; 血管成形术
Keywords:
Vena cava obstruction; Stent; Percutaneous transluminal angioplasty
分类号:
R654.3;R543.3
文献标志码:
A
摘要:
目的探讨溶栓、球囊扩张和支架置入相结合治疗恶性腔静脉梗阻的临床应用价值。方法对8例上腔静脉梗阻，21例下腔静脉梗阻分别采用球囊扩张联合支架置入（腔静脉完全梗阻和支架扩张不满意患者）、支架置入（腔静脉不完全梗阻患者），并结合溶栓治疗（腔静脉梗阻合并血栓形成患者）。结果共置入支架29枚，支架释放成功率100％。8例上腔静脉梗阻术后症状完全消退。21例下腔静脉梗阻分级评分由术前4～5分（平均4.2分）降为术后0～2分（平均0.3分）, 术前后差异有显著性意义(Z=-55.245,P=0.000)。29例随访1～20个月，平均6.2月，腔静脉通畅。1例发生腔静脉撕裂、1例术后第3天出现支架移位至右心房，其余27例术后无严重并发症发生。结论溶栓、球囊扩张和支架置入相结合是治疗腔静脉梗阻安全、有效的方法。
Abstract:
ObjectiveTo evaluate the effectiveness of combined treatment with thrombolysis, PTA, and endovascular stent placement for malignant obstruction of vena cava.MethodsThe study included 29 patients with malignant obstruction of vena cava (superior, 8 patients; inferior, 21 patients). The patients underwent treatment of PTA and endovascular stent placement (for patients with complete vena cava obstruction or patients with incompletely expanding stent), or endovascular stent placement (for patients with incomplete vena cava obstruction), or endovascular stenting combined with thrombolysis (for patients with thrombosis in vena cava), respectively.ResultsA total of 29 stents was implanted, with a success rate of stent placement of 100%. Symptoms of SVC obstruction completely disappeared in the 8 patients. Scores of patients’ IVC syndrome were declined from 4~5 (median, 4.2) preoperatively to 0~2 (median, 0.3) postoperatively, with statistically significant difference (Z=-55.245, P=0.000). Followup checkups for 1~20 months (mean, 6.2 months) in the 29 patients found patent vena cava. There were no serious complications except for vena cava laceration in 1 patient and stent displacing to the right atrium on the third day after therapy in 1 patient.ConclusionsThe combined treatment of thrombolysis, PTA, and endovascular stenting is safe and effective in the treatment of vena cava obstruction.

参考文献/References:

[1]罗剑钧,颜志平,王建华,等.下腔静脉恶性梗阻的介入治疗.中华放射学杂志,2002,36(5):430-434.
[2]Kee ST, Kinoshita L, Razavi MK, et al. Superior vena cava syndrome: treatment with catheterdirected thrombolysis and endovascular stent placement. Radiology, 1998,206:187-193.
[3]Razavi MK, Hansch EC, Kee ST. Chronically occluded inferior vena cava: endovascular treatment. Radiology, 2000,214:133-138.
[4]Nazarian GK, Austin WR, Wegryn SA, et al. Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: fouryear experience. Cardiovasc Intervent Radiol, 1996,19:227-233.
[5]Kishi K, Sonomura T, Mitsuzane K, et al. Selfexpandable metallic stent therapy for superior vena cava syndrome: clinical observations.Radiology,1993,189:531-535.
[6]Strecken EP,Hagen B,Liermann D,et al.Iliac and femoropopliteal vascular occlusive disease treated with flexible tantalum stent. Cardiovasc Intervent Radiol, 1993,16(3):158-164.
[7]Hennequin LM, Fade O, Fays JG, et al. Superior vena cava stent placement: results with the Wallstent endoprosthesis. Radiology, 1995,196(2):353-361.
[8]项军,朱耀青,王岩,等. 不同球囊导管治疗下腔静脉阻塞的回顾性分析.徐州医学院学报,2004,24(1):22-25.
[9]常钢,郭启勇,刘兆玉,等.经皮血管内支架置入术治疗腔静脉狭窄.中华放射学杂志,1995,29(5):457-460.
[10]Taneja M, Rajan, DK. Percutaneous removal of migrated Nitinol stents from the right ventricle. J Vasc Interv Radiol, 2006,17(7):1213-1215.

备注/Memo

备注/Memo:
①（北京大学第一医院介入血管外科，北京100034）
更新日期/Last Update: 2013-12-09