Vascular Medicine and Endovascular Interventions phần 10

Bộ lọc thường được triển khai dưới mức của các tĩnh mạch thận. Các tĩnh mạch thận trái truyền thống thấp hơn so với bên phải, nhưng điều này cần được xác nhận với venography tương phản trước khi vị trí bộ lọc. | CHAPTER 30 Endovascular Treatment of Venous Disease The filter is typically deployed below the level of the renal veins. The left renal vein is traditionally lower than the right but this should be confirmed with contrast venography before filter placement. Chronic Venous Insufficiency Chronic venous insufficiency is an extremely common condition with an estimated 27 of the US adult population affected by some form of lower extremity venous disease. Approximately 25 million Americans have varicose veins of varying degrees of severity with advanced severe disease in 2 to 6 million adults 500 000 have had venous ulcers. The true prevalence of varicose veins in a general population is difficult to accurately discern owing to the lack of uniformity in reporting standards and to other confounding variables in data collection that compromise the integrity of current epidemiologic studies. Chronic venous insufficiency therefore represents a substantial health problem in terms of both expenditures for care and patients quality of life. Annual health care costs for venous ulcerations in the United States are an estimated 1 billion. Endovascular Treatment of Chronic Iliac Vein Obstruction Occlusive lesions of iliac veins can result from thrombosis or extrinsic compression of the vessel and are more common on the left side. Surgical bypass to relieve iliofemoral obstruction traditionally has been used to treat this condition. Several studies have recently reported the results of endovascular management to recanalize obstructed iliac vein segments. In one of the largest series to date technical success was achieved in 97 . The rate of stent thrombosis was only 8 and 2-year primary assisted and secondary patency rates were 52 88 and 90 respectively in patients treated for PTS. May-Thurner syndrome iliocaval compression syndrome is diagnosed in 2 to 5 of patients undergoing evaluation for venous disorders of the lower extremities and if chronic may result in intraluminal venous