Abstract：
UNASSIGNED: Postthrombotic syndrome (PTS) is one of the long-term sequelae of deep vein thrombosis (DVT), and effective symptom management in pediatric PTS remains a challenge, with interventional therapy rarely explored in this population. We present a successful case of interventional treatment pediatric PTS, resulting in a remarkable amelioration of her symptoms.
UNASSIGNED: This case features a 6-year-old girl diagnosed with hyperinsulinemia, leading to a hypoglycemic coma. Following a mini-pancreatic partial pancreatectomy, she required further intensive care in the pediatric intensive care unit. It was during this period that left lower extremity DVT was identified, prompting warfarin anticoagulation therapy. During the anticoagulation period, she had several bleeding events and was switched to anticoagulation with low molecular heparin. One month later, the left common iliac vein and external iliac vein was found to be completely occluded. Over time, she experienced a gradual onset of lower limb swelling and pain, which, after 6 months, was accompanied by perineal edema and venous claudication. As a result, she underwent successful percutaneous transluminal angioplasty. In addition, the anticoagulation regimen was adjusted to rivaroxaban. At the 8-month follow-up, we observed significantly improvement in her postoperative lower extremity swelling and symptoms related to venous occlusion had completely disappeared. Moreover, vascular imaging confirmed improvement in stenosis and uninterrupted blood flow.
UNASSIGNED: In our review of pediatric PTS studies, we observed limited options to alleviate symptoms, and interventional treatments have not been reported. Our case study, demonstrating the safe and effective use of percutaneous transluminal angioplasty, helps to illuminate this area and alleviate pediatric PTS symptoms.
CONCLUSIONS: This case validates the efficacy and safety of using percutaneous transluminal angioplasty (PTA) for the treatment of postthrombotic syndrome (PTS) in pediatric patients. This interventional approach offers significant symptomatic relief and improves quality of life, especially in cases where traditional anticoagulation therapies fail or lead to complications. The successful case presented emphasizes the necessity of considering endovascular interventions for children with moderate to severe PTS, particularly when conservative management is ineffective. This research underscores the potential for PTA to be adopted in clinical practice, offering a promising new approach for managing pediatric PTS.
UNASSIGNED: This case features a 6-year-old girl diagnosed with hyperinsulinemia, leading to a hypoglycemic coma. Following a mini-pancreatic partial pancreatectomy, she required further intensive care in the pediatric intensive care unit. It was during this period that left lower extremity DVT was identified, prompting warfarin anticoagulation therapy. During the anticoagulation period, she had several bleeding events and was switched to anticoagulation with low molecular heparin. One month later, the left common iliac vein and external iliac vein was found to be completely occluded. Over time, she experienced a gradual onset of lower limb swelling and pain, which, after 6 months, was accompanied by perineal edema and venous claudication. As a result, she underwent successful percutaneous transluminal angioplasty. In addition, the anticoagulation regimen was adjusted to rivaroxaban. At the 8-month follow-up, we observed significantly improvement in her postoperative lower extremity swelling and symptoms related to venous occlusion had completely disappeared. Moreover, vascular imaging confirmed improvement in stenosis and uninterrupted blood flow.
UNASSIGNED: In our review of pediatric PTS studies, we observed limited options to alleviate symptoms, and interventional treatments have not been reported. Our case study, demonstrating the safe and effective use of percutaneous transluminal angioplasty, helps to illuminate this area and alleviate pediatric PTS symptoms.
CONCLUSIONS: This case validates the efficacy and safety of using percutaneous transluminal angioplasty (PTA) for the treatment of postthrombotic syndrome (PTS) in pediatric patients. This interventional approach offers significant symptomatic relief and improves quality of life, especially in cases where traditional anticoagulation therapies fail or lead to complications. The successful case presented emphasizes the necessity of considering endovascular interventions for children with moderate to severe PTS, particularly when conservative management is ineffective. This research underscores the potential for PTA to be adopted in clinical practice, offering a promising new approach for managing pediatric PTS.
摘要：
■血栓后综合征（PTS）是深静脉血栓形成（DVT）的长期后遗症之一，儿科PTS的有效症状管理仍然是一个挑战，在这一人群中很少探索介入治疗。我们介绍了小儿PTS介入治疗的成功案例，导致她的症状明显改善。
这个病例的特点是一名6岁女孩被诊断患有高胰岛素血症,导致低血糖昏迷.小型胰腺部分切除术后，她需要在儿科重症监护室接受进一步的重症监护.正是在这段时间里，发现了左下肢DVT，提示华法林抗凝治疗。在抗凝期间,她发生了几次出血事件,并转为低分子肝素抗凝治疗.一个月后,发现左髂总静脉和髂外静脉完全闭塞。随着时间的推移,她经历了下肢肿胀和疼痛的逐渐发作，which,6个月后,伴有会阴水肿和静脉性跛行。因此,她接受了成功的经皮腔内血管成形术。此外,抗凝方案调整为利伐沙班.在8个月的随访中，我们观察到她术后下肢肿胀明显改善,与静脉阻塞相关的症状完全消失.此外，血管成像证实了狭窄和不间断血流的改善.
■在我们对儿科PTS研究的回顾中，我们观察到缓解症状的选择有限，和介入治疗尚未报道。我们的案例研究，证明安全有效地使用经皮腔内血管成形术，有助于照亮该区域并缓解儿科PTS症状。
结论：该病例验证了使用经皮腔内血管成形术（PTA）治疗小儿血栓形成后综合征（PTS）的有效性和安全性。这种介入方法提供了显着的症状缓解，并提高了生活质量，尤其是在传统抗凝治疗失败或导致并发症的情况下。提出的成功案例强调了考虑对患有中度至重度PTS的儿童进行血管内介入治疗的必要性。特别是当保守管理无效时。这项研究强调了PTA在临床实践中被采用的潜力，为管理儿科PTS提供了一种有前途的新方法。
这个病例的特点是一名6岁女孩被诊断患有高胰岛素血症,导致低血糖昏迷.小型胰腺部分切除术后，她需要在儿科重症监护室接受进一步的重症监护.正是在这段时间里，发现了左下肢DVT，提示华法林抗凝治疗。在抗凝期间,她发生了几次出血事件,并转为低分子肝素抗凝治疗.一个月后,发现左髂总静脉和髂外静脉完全闭塞。随着时间的推移,她经历了下肢肿胀和疼痛的逐渐发作，which,6个月后,伴有会阴水肿和静脉性跛行。因此,她接受了成功的经皮腔内血管成形术。此外,抗凝方案调整为利伐沙班.在8个月的随访中，我们观察到她术后下肢肿胀明显改善,与静脉阻塞相关的症状完全消失.此外，血管成像证实了狭窄和不间断血流的改善.
■在我们对儿科PTS研究的回顾中，我们观察到缓解症状的选择有限，和介入治疗尚未报道。我们的案例研究，证明安全有效地使用经皮腔内血管成形术，有助于照亮该区域并缓解儿科PTS症状。
结论：该病例验证了使用经皮腔内血管成形术（PTA）治疗小儿血栓形成后综合征（PTS）的有效性和安全性。这种介入方法提供了显着的症状缓解，并提高了生活质量，尤其是在传统抗凝治疗失败或导致并发症的情况下。提出的成功案例强调了考虑对患有中度至重度PTS的儿童进行血管内介入治疗的必要性。特别是当保守管理无效时。这项研究强调了PTA在临床实践中被采用的潜力，为管理儿科PTS提供了一种有前途的新方法。
