腔内血管成形术治疗股总动脉累及分叉处病变  

Endovascular treatment of common femoral artery lesions involving the femoral bifurcation

作　　者：郭松林[1] 袁良喜[1] 包俊敏[1] 周建[2] 景在平[1] 

机构地区：[1]第二军医大学附属长海医院血管外科,上海200433 [2]第二军医大学附属长海医院外科教研室,上海200433

出　　处：《中国血管外科杂志（电子版）》2014年第2期76-78,共3页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家自然科学基金面上项目(81370441)

摘　　要：目的探讨腔内血管成形术治疗股动脉分叉部位病变的临床疗效及技术要点。方法回顾性分析2011年9月至2013年12月15例股动脉分叉部位病变患者行腔内血管成形术治疗的临床资料。其中男性9例,女性6例;平均年龄77.2(68～84)岁。按Rutherford分级:重度间歇性跛行(3级)5例,静息痛(4级)7例,足踝部溃疡或足趾坏疽(5级)3例。所有病例先处理股总及股浅动脉病变段再同期处理股深动脉病变。结果总技术成功率为100%。3例行单纯股总动脉+股深动脉球囊扩张术(PTA),4例行股总动脉支架成形术,5例行股浅动脉支架成形术,3例行单纯股总动脉+股浅动脉PTA术。术后所有患肢皮肤温度均明显升高,疼痛消失或减轻。6个月复查,踝肱指数平均上升0.52±0.16;一期通畅率为73.3%,未发生支架断裂。结论对于累及股动脉分叉部位病变,采用腔内血管成形术完全重建股总、股浅及股深动脉,有利于改善肢体缺血症状及预后。Objective To evaluate the efficacy of endovascular treatment of common femoral artery(CFA) lesions involving the femoral bifurcation. Methods Between September 2011 and December 2013, a consecutive series of 15 patients(9 male and 6 female patients) with femoral bifurcation steno-obstructive disease received percutaneous angioplasty. The mean age was 77.2 years(68～84 years). There were 5 cases with severe claudication(Rutherford category 3) and 10 cases with critical limb ischemia(Rutherford category 4～5). The deep femoral artery lesions were treated simultaneously with the common/superficial femoral artery lesions. Results The technical success rate was 100%. Three cases underwent balloon angioplasty in common and deep femoral artery; 4 cases underwent stenting in CFA; 5 cases underwent stenting in superficial femoral artery; the other 3 cases underwent balloon angioplasty in common and superficial femoral artery. The clinical manifestation had significantly improved after interventions. There was a increase of 0.52±0.16 of anklebrachial index after 6 months follow-up. Primary patency rate was 73.3% without stent fracture. ConclusionSimultaneously endovascular revascularization of the common, superficial and deep femoral artery can improve ischemic symptoms and prognosis in patients with femoral bifurcation steno-obstructive disease.

关 键 词：动脉硬化闭塞症 股动脉 血管成形术 

分 类 号：R654.4[医药卫生—外科学]