초록접수 현황
| 15F-028 | 구연 발표 |
Comparison of the Clinical Results of Catheter Directed Thrombectomy in Iliac Vein Thrombosis According to Whether Patients have May-Thurner Syndrome or Not
김인섭¹, 조원민¹,², 신재승², 민병주², 황진욱²
고려대학교 의과대학 대학원 의학과 흉부외과학교실¹, 고려대학교 의과대학 안산병원 흉부외과학교실²
Background : May-Thurner syndrome (MTS), a kind of venous compression syndrome is caused by compression of iliac vein from iliac artery and spine. Venous compression leads to venous hypertension and venous thrombosis. Therefore, May-Thurner syndrome has different pathophysiology from general deep vein thrombosis (DVT). However, the clinical results of MTS has been reported very few. The aim of this study is to analyze the clinical results of catheter-directed thrombectomy in the DVT according to whether it caused by MTS or not.
Methods : We reviewed iliac vein thrombosis followed by catheter-directed thrombectomy from January, 2004 to December, 2013. All patients who enrolled MTS patients were 25 patients (MTS group) and the other group who have iliac DVT without venous compression followed by catheter-directed thrombectomy were also 22 patients (non-MTS group). Medical records of these patients were reviewed retrospectively.
Results : Follow up periods were mean 29.9±29.5 months. Among risk factors, sex (MTS female 76.0%, non-MTS 59.1%, p=0.01) and Body mass index(BMI) (MTS BMI=27.02±3.93, non-MTS BMI=23.89±3.17, p=0.01) were different between groups. Procedure time and duration of anticoagulation were comparable between groups. The periods of warfarin medication were 26.4±26.9 months for MTS and 22.8±23.0 months (p=0.40). All patents of MTS and 7 patients of non-MTS were inserted venous stent in the iliac vein. Although the incidence of remnant thrombus at discharge was higher in non-MTS (MTS 3 cases (12%), non-MTS 7 cases (31.8%)), there was no statistical significance. Recurrence and residual thrombus free rate during follow up were higher in MTS. Recurrence free rate at 1,3 and 5 years were 96%, 92%, 92% in MTS and 81%, 81%, 81% in non-MTS group (p=0.18). Residual thrombus free rate at 1,3 and 5 years were 96%, 88%, 88% in MTS and 72.7%, 72.7%, 72.7% in non-MTS group (p =0.12).
Conclusion : Although, the pathophysiologic difference between MTS and DVT, the clinical result of both disease showed similar results of catheter-directed thrombectomy. Therefore, recent advance of catheter-directed thrombectomy might play an important role as an initial therapy in MTS patients
Methods : We reviewed iliac vein thrombosis followed by catheter-directed thrombectomy from January, 2004 to December, 2013. All patients who enrolled MTS patients were 25 patients (MTS group) and the other group who have iliac DVT without venous compression followed by catheter-directed thrombectomy were also 22 patients (non-MTS group). Medical records of these patients were reviewed retrospectively.
Results : Follow up periods were mean 29.9±29.5 months. Among risk factors, sex (MTS female 76.0%, non-MTS 59.1%, p=0.01) and Body mass index(BMI) (MTS BMI=27.02±3.93, non-MTS BMI=23.89±3.17, p=0.01) were different between groups. Procedure time and duration of anticoagulation were comparable between groups. The periods of warfarin medication were 26.4±26.9 months for MTS and 22.8±23.0 months (p=0.40). All patents of MTS and 7 patients of non-MTS were inserted venous stent in the iliac vein. Although the incidence of remnant thrombus at discharge was higher in non-MTS (MTS 3 cases (12%), non-MTS 7 cases (31.8%)), there was no statistical significance. Recurrence and residual thrombus free rate during follow up were higher in MTS. Recurrence free rate at 1,3 and 5 years were 96%, 92%, 92% in MTS and 81%, 81%, 81% in non-MTS group (p=0.18). Residual thrombus free rate at 1,3 and 5 years were 96%, 88%, 88% in MTS and 72.7%, 72.7%, 72.7% in non-MTS group (p =0.12).
Conclusion : Although, the pathophysiologic difference between MTS and DVT, the clinical result of both disease showed similar results of catheter-directed thrombectomy. Therefore, recent advance of catheter-directed thrombectomy might play an important role as an initial therapy in MTS patients
책임저자: 조원민
고려대학교 의과대학 안산병원 흉부외과학교실
연락처 : 김인섭, Tel: 010-9071-1125 , E-mail : csdanwon@gmail.com
