초록접수 현황
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Hybrid Treatment of DVT by Posterior Tibial Vein at Only Supine Position
공준혁, 오태윤, 오삼세, 유병수
성균관대학교 의과대학 강북삼성병원 흉부외과학교실
목적 : Recently, there have been very important developments in our understanding of deep vein thrombosis(DVT). It is now a treatable disease at all stages, and new technologies, such as dedicated venous stents and pharmacomechanical thrombolysis, will translate into a better quality of life for patients. The goal of this study is to present our technique of hybrid treatment including 018-guided wire based Forgaty catheter thrombectomy and iliocaval stenting of deep vein thrombosis at Semi-hybrid operation room in the selective DVT patients.
방법 : Operation was performed in only supine position with IVC filter insertion via right common femoral vein(CFV), hybrid thrombectomy via left CFV and posterior tibial vein(PTV) and stenting in left common iliac vein(CIV). In this method, CFV and PTV are to be exposed for 018 wire-guided Forgaty catheter thrombectomy in order that patient is in only supine position. On angiography, there was stenotic portion in left CIV as May-Thurner syndrome and stening was performed and the final angiography revealed good flow through left CIV. In conclusion, with PTV exposure, we could remove thrombi in whole length of leg vein successfully and gently.
결과 : A database was collected for the period 2011 through 2014 and was prospectively reviewed. 24 patients (19 males), with median age of 68 years, had hybrid procedure. There were 18 cases of Mayer-Thurner syndrome. There were completely resolved deep vein thromsosis without remained thrombosis and no recurrence during follow-up period (1mo-36mo). except two patients.
결론 : In this method, there are some points ; 1) whole procedure could be done in only supine position. 2) stenting in left CIV could be performed safely because venography through right CFV reveal the accurate site of bifucation of both CIV. 3) with PTV exposure, we could remove thrombi in whole length of leg vein successfully.
방법 : Operation was performed in only supine position with IVC filter insertion via right common femoral vein(CFV), hybrid thrombectomy via left CFV and posterior tibial vein(PTV) and stenting in left common iliac vein(CIV). In this method, CFV and PTV are to be exposed for 018 wire-guided Forgaty catheter thrombectomy in order that patient is in only supine position. On angiography, there was stenotic portion in left CIV as May-Thurner syndrome and stening was performed and the final angiography revealed good flow through left CIV. In conclusion, with PTV exposure, we could remove thrombi in whole length of leg vein successfully and gently.
결과 : A database was collected for the period 2011 through 2014 and was prospectively reviewed. 24 patients (19 males), with median age of 68 years, had hybrid procedure. There were 18 cases of Mayer-Thurner syndrome. There were completely resolved deep vein thromsosis without remained thrombosis and no recurrence during follow-up period (1mo-36mo). except two patients.
결론 : In this method, there are some points ; 1) whole procedure could be done in only supine position. 2) stenting in left CIV could be performed safely because venography through right CFV reveal the accurate site of bifucation of both CIV. 3) with PTV exposure, we could remove thrombi in whole length of leg vein successfully.
책임저자: 공준혁
성균관대학교 의과대학 강북삼성병원 흉부외과학교실
연락처 : 공준혁, Tel: 02-2001-2407 , E-mail : society@ktcs.or.kr
