【摘要】 目的:探讨以腔内技术为核心治疗Cockett综合征的中远期结果。方法:回顾性分析2003年1月—2014年2月间收治的412例Cockett综合征患者的临床资料,其中急性左髂股静脉血栓形成231例(A组),慢性静脉功能不全181例(B组),分别采用不同的腔内技术和/或复合手术治疗。结果:A组技术成功率100%(231/231);5例左髂总静脉无狭窄或闭塞,左髂静脉病变率97.8%(226/231);共植入髂静脉支架182枚。B组技术成功率99.4%(180/181);共植入支架151枚;1例患者术中行球囊扩张成形时左髂静脉破裂而致腹膜后巨大血肿、失血性休克,经积极抢救后好转;手术前后病变左髂静脉远心端与近心端压力差由术前(18±4.45)cmH2O降至术后(4±3.02)cmH2O(P<0.01);89例患者合并有左股浅静脉重度瓣膜功能不全,二期行股静脉瓣膜修复术。随访3个月至8年,平均35.6个月,A组15例、B组2例支架内血栓形成。结论:腔内技术为核心治疗Cockett综合征具有较好的中远期效果。对于合并急性髂股静脉血栓形成者,联合应用Forgarty导管取栓或导管接触溶栓是腔内治疗一种有益的补充。更多还原

【Abstract】 Objective:To investigate the mid-and long-term results of endovascular-based procedures for Cocket syndrome.Methods:h e clinical data of 412 patients with Cocket syndrome treated between January 2003 and February 2014 were retrospectively analyzed.In these patients,231 cases were acute let iliac femoral vein thrombosis(group A),and 181 cases were chronic venous insui ciency(group B),and dif erent endovascular procedures and/or hybrid procedures were performed.Results:In group A,the technique success rate was 100%(231/231);the left iliac vein in 5 patients showed no stenosis or occlusion,and the incidence of pathological changes in the let iliac vein was 97.8%(226/231);a total of 182 stents were implanted.In group B,the technique success rate was 99.4%(180/181);one patient developed a large retroperitoneal hematoma and hemorrhagic shock due to rupture of the let iliac vein during balloon-inl ation angioplasty,and was resuscitated by aggressive ef orts;the average pressure dif erence between the proximal and distal portion of the pathological let iliac veins decreased from preoperative(18±4.45) cmH2O to postoperative(4±3.02) cmH2O(P<0.01);89 patients,complicated with valvular incompetence in the left superi cial femoral vein,underwent a second-stage femoral valve repair.Follow-up ranged from 3 months to 8 years,with an average of 35.6 months,and intrastent thrombosis occurred in 15 cases of group A and in 2 cases of group B.Conclusion:Endovascular-based procedures of er favorable mid-and long-term results in treatment of Cocket syndrome,which in combination with Fogarty catheter thrombectomy or catheter-directed thrombolysis is a benei cial complementary treatment for those complicated with acute iliac femoral vein thrombosis.更多还原