Interventional treatment of primary long-segment infrahepatic inferior vena cava occlusion

doi:10.11958/20260148

Abstract

Abstract:

Objective To evaluate the efficacy of interventional treatment of primary long-segment infrahepatic inferior vena cava (IIVC) occlusion. Methods The clinical data of 28 patients with primary long-segment IIVC occlusion were retrospectively analyzed, including 11 patients complicated with inferior vena cava or iliac vein thrombosis. All patients underwent digital subtraction angiography (DSA) to determine the extent of the lesion and subsequently received interventional treatment. Changes in the distal-to-proximal pressure gradient across the inferior vena cava, the venous clinical severity score (VCSS) and the clinical-etiology-anatomy-pathophysiology (CEAP) classification were compared before and after treatment. Results Interventional treatment was successfully completed in all patients, and recanalization of the inferior vena cava was achieved in every case. Balloon dilation alone was performed in 24 patients, and stent implantation was performed in 4 patients. Among the 11 patients with thrombosis, catheter-directed thrombolysis was performed before angioplasty, and no severe complications occurred. The distal-to-proximal pressure gradient across the inferior vena cava decreased significantly after treatment (P<0.01). One month after the procedure, both the CEAP classification and VCSS score were generally improved compared with those before treatment (both P<0.01). During follow-up, 19 patients maintained patency of the inferior vena cava, whereas 9 developed restenosis, all were successfully recanalized by repeat interventional treatment. Conclusion Interventional treatment for primary long-segment IIVC occlusion is safe and effective, and can significantly improve lower-extremity venous symptoms, providing evidence for minimally invasive treatment strategies in clinical practice.

Key words: vena cava, inferior, radiology, interventional, venous thrombosis, occlusion

CLC Number:

R654.3

Figures/Tables 2

References 26

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时期	CEAP分级
时期	C0	C1	C2	C3	C4	C5	C6
术前	0（0.0）	3（10.7）	7（25.0）	4（14.3）	5（17.9）	2（7.1）	7（25.0）
术后1个月	7（25.0）	7（25.0）	3（10.7）	0（0.0）	2（7.1）	4（14.3）	5（17.9）
Z	3.724^＊＊

时期	CEAP分级
时期	C0	C1	C2	C3	C4	C5	C6
术前	0（0.0）	3（10.7）	7（25.0）	4（14.3）	5（17.9）	2（7.1）	7（25.0）
术后1个月	7（25.0）	7（25.0）	3（10.7）	0（0.0）	2（7.1）	4（14.3）	5（17.9）
Z	3.724^＊＊