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中华介入放射学电子杂志 ›› 2017, Vol. 05 ›› Issue (04) : 288 -292. doi: 10.3877/cma.j.issn.2095-5782.2017.04.017

所属专题: 文献

综述

Paget-Schroetter综合征的诊疗进展
石浩钒1, 顾建平1,(), 施万印1   
  1. 1. 210006 南京医科大学附属南京医院(南京市第一医院)介入血管科
  • 收稿日期:2017-07-23 出版日期:2017-11-01
  • 通信作者: 顾建平

Research progress on diagnosis and treatment of Paget-Schroetter Syndrome

Haofan Shi1, Jianping Gu1,(), Wanyin Shi1   

  1. 1. Department of Interventional Radiology, Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing 210006, China
  • Received:2017-07-23 Published:2017-11-01
  • Corresponding author: Jianping Gu
  • About author:
    Corresponding author: Gu Jianping, Email:
引用本文:

石浩钒, 顾建平, 施万印. Paget-Schroetter综合征的诊疗进展[J/OL]. 中华介入放射学电子杂志, 2017, 05(04): 288-292.

Haofan Shi, Jianping Gu, Wanyin Shi. Research progress on diagnosis and treatment of Paget-Schroetter Syndrome[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2017, 05(04): 288-292.

Paget-Schroetter综合征(Paget-Schroetter syndrome,PSS)即原发性锁骨下-腋静脉血栓形成,多见于健康青壮年,尤其在肩关节长时间外展或超负荷运动后容易出现。DSA是诊断的"金标准"。除了传统的肢体抬高、单纯抗凝治疗和外科解压手术,随着病因学研究不断加深,逐渐出现针对PSS的介入治疗,包括导管接触性溶栓,机械血栓清除术和血管成形术等。由于这些患者可能存在胸廓出口的解剖变异,而胸廓出口处的持续压迫,易造成支架扭曲甚至断裂。但新型编织支架的临床应用,为PSS的介入治疗提供新的思路。

Paget-Schroetter syndrome (PSS) , primary subclavian-axillary vein thrombosis, most often occurs in young adults, especially after a period of unaccustomed vigorous exercise or prolonged shoulder abduction. DSA is the gold standard for diagnosis. Besides the traditional limb elevation, anticoagulant therapy and surgical decompression, with the advancement of etiology, some interventional treatment options have been applied to the management of PSS, including catheter-directed thrombolysis, pharmaco-mechanical thrombectomy, angioplasty, etc. These patients may have anatomical variants in thoracic outlet, as a result, the persistent compression in this area can induce stent kinking or fragmentation. But the employment of new interwoven stent system provides fresh ideas for the interventional treatment of PSS.

图1 锁骨下静脉走行于第一前肋和锁骨之间的间隙(肋锁间隙)
图2 Paget-Schroetter综合征的DSA表现
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