外科理论与实践

外科理论与实践 >

2024 , Vol. 29 >Issue 06: 481 - 486

DOI: https://doi.org/10.16139/j.1007-9610.2024.06.04

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髂股静脉术后支架内再狭窄因素的分析及处理

  • 续慧民 ,
  • 高红霞
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  • 山西白求恩医院(山西医学科学院) 山西医科大学第三医院同济山西医院 血管外科，山西 太原 030032
续慧民，E-mail: 343070687@qq.com

收稿日期: 2024-10-09

  网络出版日期: 2025-03-17

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Management of in-stent restenosis after iliofemoral venous stenting

  • XU Huimin ,
  • GAO Hongxia
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  • Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Shanxi Taiyuan 030032, China

Received date: 2024-10-09

  Online published: 2025-03-17

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摘要

髂股静脉支架植入术（IVS）是目前治疗各类急慢性深静脉阻塞疾病的一线治疗措施，有效改善临床症状。然而，IVS后发生支架内再狭窄（ISR）是影响支架通畅及造成再干预的主要原因。ISR是复杂的病理生理过程，与术前狭窄程度、病变特征、支架位置、支架受压程度、支架流入道面积以及其他生物学力学因素等多种危险因素有关。对于ISR的处理目前仍以球囊扩张为主要治疗手段，还应注重术后随访及监测，合理使用抗凝或抗血小板药物，把握合适的手术指征，根据病人情况选择合理的治疗方法。激光消融、动脉内膜切除装置以及放射治疗可能成为未来治疗ISR的新方法。

关键词： 髂股静脉支架植入术; 再狭窄; 危险因素

本文引用格式

续慧民 , 高红霞 . 髂股静脉术后支架内再狭窄因素的分析及处理[J]. 外科理论与实践, 2024 , 29(06) : 481 -486 . DOI: 10.16139/j.1007-9610.2024.06.04

Abstract

Iliofemoral venous stent placement (IVS) is currently the first-line treatment for various acute and chronic deep vein obstruction diseases, effectively improving clinical symptoms in patients. However, in-stent restenosis (ISR) after IVS is a major cause of stent-occlusion issues and re-intervention. ISR is a complex pathophysiological process related to multiple risk factors, including preoperative stenosis severity, lesion characteristics, stent position, stent compression, inflow area of the stent, and other biomechanical factors. Currently, the management of ISR primarily involves balloon dilation, it is also essential to emphasize postoperative follow-up and monitoring, rational use of anticoagulant or antiplatelet medications, appropriate surgical indications, and choosing the right treatment method based on patient conditions. Laser ablation, intravascular endarterectomy devices, and radiation therapy may become new options for ISR treatment in the future.

Key words： Iliofemoral venous stent placement(IVS); In-stent restenosis(ISR); Risk factor

参考文献

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