Short And Medium-term Efficacy Analysis Of Percutaneous Transluminal Angioplasty Combined With Endovascular Stent Implantation In Treatment Of Non-thrombotic Iliac Vein Compression Syndrome

Purpose:To explore the clinical efficacy and safety of percutaneous transluminal angioplasty(PTA)combined with endovascular stent implantation in the first-stage treatment of non-thrombotic iliac vein compression syndrome(NIVCS),so as to provide a more adequate basis and prospect for the endovascular treatment.Method:The clinical data of 66 patients with NIVCS,who underwent endovascular treatment in the Second Affiliated Hospital of Guangzhou Medical University from January 2016 to May 2019,were retrospectively analyzed.They were divided into two groups: PTA group(control group,29 cases)and PTA+STENT group(observation group,37 cases)according to their treatment methods.Compare the clinical efficacy between pre-operation and postoperation of all patients and analysis whether there was a statistical difference in the drop of Venous Clinical Severity Score(VCSS)during the follow-up when compared the two groups.Result:Sixty-six patients with NIVCS were followed up for 12-52 months(24.7±9.2 months).The average age was(64.2±11.4years).No statistical difference is observed in the clinical data such as age,gender,clinical etiology anatomic pathphysiologic(CEAP)grade and lesion side between two groups.The success rate of operation was 100% of all patients.After endovascular treatment,re-angiography confirmed that iliac vein stenosis or occlusions were relieved at different degrees,and pelvic collateral circulation was significantly reduced.In most patients,the limb pain was significantly relieved even disappeared in 3 months after endovascular treatment,with the pain relief rate of 87.5%(14/16)in the observation group and 85.7%(12/14)in the control group.Most patients declare that their symptoms of limb swelling were disappeared or significantly alleviated,with the remission rate of the swelling in the observation group 90.4%(19/21),and the control group 88.9%(16/18).And there was also a significant ulcer improvement and healed at different degrees for most patients,which in observation group was 83.3%(5/6),and control group was 50%(1/2).VCSS scores of post operation were seriously lower than pre-operation at all follow-up time,and there were significant statistical differences(all P < 0.05).Both of the two endovascular treatment methods had significant short-term and medium-term efficacy.There were no significant statistical differences between two endovascular treatment methods when compare their VCSS average score at 3 and 6 months after operation.But there were significant statistical differences when compare their VCSS average score at 12,24 and 36 months after operation.Conclusion:Endovascular treatment(PTA and PTA+STENT)of NIVCS both have a high technical success rate,which can significantly relieve the clinical symptoms of patients,with nice profit at short-term and medium-term.PTA+STENT is a safety and effective method for the patient with NIVCS,which has less complication,a higher patency rate at short-term and medium-term.Further,PTA+STENT shows a more significant efficacy than PTA alone after 12 month postoperation,but they have equal effective at within 6 month postoperation.