锁骨下动脉阻塞支架置入50例临床分析  

Interventional therapy for subclavian arterial occlusion: A clinical study of 50 cases

作　　者：俞恒锡[1] 张建[1] 汪忠镐[1] 李建新[1] 谷涌泉[1] 李慎茂[1] 朱风水[1] 缪中荣[1] 陈兵[1] 郭连瑞[1] 

机构地区：[1]首都医科大学宣武医院血管外科首都医科大学血管外科研究所介入中心,北京100053

出　　处：《中国微创外科杂志》2006年第11期827-829,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腔内支架置入治疗锁骨下动脉闭塞症的临床疗效。方法2001年5月-2006年4月，我院采用腔内支架置入治疗锁骨下动脉闭塞50例53支病变。45例经股动脉顺行，5例经腋动脉逆行支架置入。7例伴有颈动脉或椎动脉严重狭窄同期行支架置入。结果术后患肢血压测定均较术前明显提高，患／健侧血压指数由术前0．69±0．12提高至术后0．98±0．11（t=9．731，P=0．000）。43例随访3—60个月，平均14．5月，锁骨下动脉再狭窄率（〉50％）11．6％（5／43）。结论腔内介入支架治疗锁骨下动脉严重狭窄和闭塞是一种安全、有效的方法，为临床首选。Objective To investigate clinical outcomes of endovascular stent placement in the treatment of subclavian arterial occlusion. Methods Fifty patients with subclavian arterial occlusion underwent endovascular stent placement from May 2001 to April 2006. The occlusive lesions were identified by arteriography before operation, and the vascular patency was examined by Doppler ultrasonography during follow-up checkups. The stent was introduced through the femoral atery anterogradely in 45 patients and through the axillary artery retrogradely in 5 patients. Concurrent stent placement was performed in 7 patients with severe carotid artery stenosis or vertebral artery stenosis. Results The blood pressure increased remarkably after operation, with the affected-to-normal-side blood pressure index increased from 0.69 ＋ 0. 12 preoperatively to 0.98 ＋ 0. 11 postoperatively （ paired t-test, t = 9. 731, P = 0. 000 ）. Follow-up examinations in 43 patients for 3 - 60 months （ mean, 14. 5 months） revealed a recurrent stenosis （ 〉 50% ） rate of 11.6%. Conclusions Endovascular stent placement is a safe and effective procedure and may be selected as the first choice for severe subclavian arterial occlusion. Short-term follow-up shows a satisfactory clinical outcome.

关 键 词：介入治疗 支架 锁骨下动脉阻塞 

分 类 号：R743[医药卫生—神经病学与精神病学]