METHODS: Medical records of iliac vein molding and stenting performed in the ipsilateral great saphenous vein approach conducted from February 2017 to March 2022 were retrospective reviewed. There were 21 cases, 6 males and 15 females. Age ranged from 37 to 79 years [(62.5 ± 10.2) years]. The stenosis in the 21 limbs simply involved the common iliac veins in 16 patients, 2 patients had the simple and external iliac veins, and both the total and external iliac veins in 3 patients. Both iliac vein molding and iliac vein stenting were performed through the ipsilateral great saphenous vein approach. The patients with simple iliac vein stenosis with great saphenous vein valve insufficiency also underwent radiofrequency closure of great saphenous vein and flexural vein sclerosis therapy simultaneously. Regular postoperative direct oral anticoagulants therapy and stress therapy were followed. All the patients were hospitalized for less than 24 h.
RESULTS: All the 21 patients operations were successful (the success rate was 100%), without any intraoperative complications. Immediate postoperative complications were puncture point bleeding in 1 case. The bandage gauze was completely wet. The bleeding was stopped after 5min of recompression. All the patients were hospitalized for less than 24 h. Follow-up results: The 3-month follow-up rate after operation was 100%. Absolute effective 18 cases (18/21, 85.7%). Relatively effective(postmentation still after surgery, but with less extent) in 3 cases (3/21, 14.3%). The iliac vein stents were unobstructed, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment. The 6-month follow-up rate after operation was 71.4%(15/21). Of these, 14 cases (14/15, 93.3%) were absolutely effective. Relatively effective(postmentation still after surgery, but with less extent) in 1 case (1/15, 6.7%). The iliac vein stents were no restenosis or obstruction, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment.
CONCLUSIONS: The interventional treatment technique of iliac vein stenosis is feasible in the daytime treatment mode, with clear advantages and satisfactory recent efficacy.
方法:回顾性分析2017年2月至2022年3月在同侧大隐静脉入路进行髂静脉成型和支架置入的病历。有21例,男性6人,女性15人。年龄37~79岁[(62.5±10.2)岁]。16例患者21肢狭窄仅累及髂总静脉,2例患者有单纯和髂外静脉,3例患者的总静脉和髂外静脉。髂静脉成型和髂静脉支架置入均通过同侧大隐静脉入路进行。单纯髂静脉狭窄合并大隐静脉瓣膜功能不全的患者同时行大隐静脉射频封堵术和弯曲静脉硬化治疗。术后定期直接口服抗凝剂治疗和应激治疗。所有患者均住院24h以内。
结果:21例患者手术均成功(成功率100%),无任何术中并发症。术后即刻并发症为穿刺点出血1例。绷带纱布是完全湿的。再压缩5min后停止出血。所有患者均住院24h以内。随访结果:术后3个月随访率为100%。绝对有效18例(18/21,85.7%)。相对有效(手术后仍保持镇静,但程度较小)3例(3/21,14.3%)。髂静脉支架通畅,大隐静脉射频治疗的患者大隐静脉主干闭合良好。术后6个月随访率为71.4%(15/21)。其中,14例(14/15,93.3%)绝对有效。相对有效(手术后仍保持镇静,但程度较小)1例(1/15,6.7%)。髂静脉支架没有再狭窄或阻塞,大隐静脉射频治疗的患者大隐静脉主干闭合良好。
结论:髂静脉狭窄的介入治疗技术在日间治疗模式下是可行的。优点明显,近期疗效满意。