Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe?
Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe?
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DOI：
10.1258/phleb.2010.010053
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发表时间：
2010-12-01
期刊：
影响因子：
1.7
通讯作者：
Tochowicz, M.
中科院分区：
文献类型：
--
作者：
Ludyga, T.;Kazibudzki, M.;Tochowicz, M.
目的：本报告的目的是评估血管内治疗慢性脑脊髓静脉功能不全（CCSVI）的安全性。尽管球囊血管成形术和支架植入术似乎是安全的手术，但目前还没有大量血管病变患者的治疗数据。方法：对331例伴有多发性硬化症的CCSVI患者进行了344次干预，共564次血管内手术（球囊血管成形术，如果该手术失败，则支架植入术）。结果：单纯行球囊血管成形术192例（55.8%），行至少一条静脉支架置入术152例（44.2%）。除2例（1.2%）发生血栓性支架闭塞和1例（0.3%）手术打开股静脉取出成形性球囊外，该手术未发生重大并发症（大出血、静脉血栓形成、支架移位或神经损伤）。次要并发症包括偶尔出现的技术问题（2.4%的手术）：难以取出血管成形术球囊或支架的正确放置问题，以及其他医疗事件（2.1%的手术）：腹股沟局部出血、轻微胃肠道出血或心律失常。结论：无论静脉病理血管内治疗对多发性硬化症临床病程的实际影响如何，该手术似乎是安全的，患者耐受性良好，值得长期随访。
Objectives: The aim of this report is to assess the safety of endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI). Although balloon angioplasty and stenting seem to be safe procedures, there are currently no data on the treatment of a large group of patients with this vascular pathology.Methods: A total of 564 endovascular procedures (balloon angioplasty or, if this procedure failed, stenting) were performed during 344 interventions in 331 CCSVI patients with associated multiple sclerosis.Results: Balloon angioplasty alone was performed in 192 cases (55.8%), whereas the stenting of at least one vein was required in the remaining 152 cases (44.2%). There were no major complications (severe bleeding, venous thrombosis, stent migration or injury to the nerves) related to the procedure, except for thrombotic occlusion of the stent in two cases (1.2% of stenting procedures) and surgical opening of femoral vein to remove angioplastic balloon in one case (0.3% of procedures). Minor complications included occasional technical problems (2.4% of procedures): difficulty removing the angioplastic balloon or problems with proper placement of stent, and other medical events (2.1% of procedures): local bleeding from the groin, minor gastrointestinal bleeding or cardiac arrhythmia.Conclusions: The procedures appeared to be safe and well tolerated by the patients, regardless of the actual impact of the endovascular treatments for venous pathology on the clinical course of multiple sclerosis, which warrants long-term follow-up.