Endovascular management of Cockett syndrome complicated by deep vein thrombosis

Objective To evaluate the efficacy of endovascular comprehensive treatment for Cockett syndromen complicated by deep venous thrombosis.Methods From 2009 to 2011,85 Cockett syndrome patients complicated with deep vein thrombosis of the lower extremities were treated by catheterdirected thrombolysis (CDT).After 5-7 days all patients were reevaluated by angiography.Balloon dilatation carried out,and/or stent was placed while stenosis or iliac vein thrombosis was found.Postoperative treatment consisted of anticoagulant,thrombolytic,intravenous active drug,sequential air pressure,and wearing medical compression stockings.Results Permanent filters were placed in 6 cases,after CDT treatment the iliac vein patency rate was 67.2％,balloon dilatation alone in 36 cases,balloon dilation plus stent in 49 cases.There was no symptomatic pulmonary embolism,no bleeding,nor mortality.79 cases (92.94％) were followed-up from 6 mos to 24 mos with 67 cases receiving vascular ultrasound examination,12 cases by CT angiography.The 18 months patency rate was 94.94％ (75/79).Deep venous thrombosis recurred in 4 cases (5.06％),including two cases after filter placement.At the end of followup,the current signs and symptoms includes venous claudication in 24 cases (30.38％),limb edema in 41 cases (51.9％),ankle skin pigmentation in 5 cases (6.33％),limb varicose veins in 4 cases (5.06％).Conclusions CDT with transluminal angioplasty is a safe,effective,minimally invasive for the treatment of Cockett syndrome complicated with deep venous thrombosis. Key words: Venous thrombosis ;  Angioplasty ;  Cockett syndrome