CAJ | 학술논문

目的：探讨应用双股静脉入路血管腔内技术治疗左髂-股静脉血栓(LI-FVT)的有效性。方法左下肢深静脉急性血栓，先经右侧股静脉置入下腔静脉滤器，向左侧髂静脉逆行插管；对逆行插管失败的患者，行左侧股静脉穿刺插管，顺行开通左侧股-髂静脉至下腔静脉内。对血栓闭塞段应用溶栓导管(OASIS)持续接触性溶栓3～4 d，对溶栓后髂股静脉流出道明显狭窄者，行球囊扩张支架植入术。结果12例经双股静脉入路治疗者，10例技术成功，均取得明显的疗效，表现为患肢肿胀迅速消退，疼痛消失，肢体松软，活动恢复正常；1例行球囊扩张支架植入术；另外2例未成功置管改行经左小隐静脉置管持续溶栓术。术后随访3～9个月，平均6.6个月，无症状性复发及肺栓塞。结论双股静脉入路治疗I-FVT,成功率高、安全、创伤小临床应用可行。
목적：탐토응용쌍고정맥입로혈관강내기술치료좌가-고정맥혈전(LI-FVT)적유효성。방법좌하지심정맥급성혈전，선경우측고정맥치입하강정맥려기，향좌측가정맥역행삽관；대역행삽관실패적환자，행좌측고정맥천자삽관，순행개통좌측고-가정맥지하강정맥내。대혈전폐새단응용용전도관(OASIS)지속접촉성용전3～4 d，대용전후가고정맥류출도명현협착자，행구낭확장지가식입술。결과12례경쌍고정맥입로치료자，10례기술성공，균취득명현적료효，표현위환지종창신속소퇴，동통소실，지체송연，활동회복정상；1례행구낭확장지가식입술；령외2례미성공치관개행경좌소은정맥치관지속용전술。술후수방3～9개월，평균6.6개월，무증상성복발급폐전새。결론쌍고정맥입로치료I-FVT,성공솔고、안전、창상소림상응용가행。
Objective To evaluate the efficiency of endovascular of iliac-femoral venous thrombus(I-FVT) via double femoral veins. Methods Twelve patients with I-FVT were treated with implantation of inferior vena caval filter,ten patients treated with OASIS catheter via double femoral veins. After operation,the catheter was kept in iliac-femoral veins for three to four days. Some patients were treated with balloon-directed extend and one was stented. Results The endovascular was successful in ten patients. Swollen symptom of lower limb and pain disappeared in those patients. The treatment was fail in two patient. Follow-up study showed no pulmonary embolization or recrudescence in all twelve patients. Conclusion The endovascular of I-FVT via double femoral veins is a safe and minimally-invasive with higher success rate technique.