下肢动脉闭塞性病变介入治疗的近期疗效观察  

Short-term clinical results of interventional therapy for occlusive arteries in lower limbs

作　　者：秦永林[1] 邓刚[1] 郭金和[1] 何仕诚[1] 方文[1] 朱光宇[1] 滕皋军[1] 

机构地区：[1]东南大学附属中大医院介入与血管外科,江苏南京210009

出　　处：《东南大学学报（医学版）》2009年第2期122-125,共4页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:采用介入球囊扩张成形结合支架植入治疗下肢动脉完全闭塞性病变,并观察治疗的可行性和近期疗效。方法:2007年1月至2008年1月我科收治的下肢动脉闭塞性病变患者18例,采用常规或者内膜下成形技术对完全闭塞性病变进行扩张,根据扩张后病变变化选择性使用支架植入。观察术中及术后并发症的发生率、技术有效率和临床有效率,通过随访,判断治疗的初始通畅率、救肢率和生存率。结果:18例患者早期技术性的并发症1例(5.6%),为穿刺部位假性动脉瘤。动脉闭塞性病变再通的技术有效率髂、股、腘动脉为11/12,胫前动脉为6/14,胫后动脉为9/16,腓动脉为4/11,总的技术有效率为30/53,临床有效率为17/18。髂股段再通后支架植入16枚。术后平均住院时间8 d。术后6个月初始通畅率、救肢率和生存率分别为27/30、16/18和17/18。结论:对于下肢动脉完全闭塞性病变的患者,采用介入方法治疗的技术有效率与病变部位有关,可以达到理想的救肢率和生存率,操作死亡率和并发症的发生率都比较低,是一可用的、安全的、有效的治疗方法。Objective To review the feasibility, safety and efficacy of percutaneous transluminal angioplasty （PTA） combined with stent implantation for the treatment of occlusive atherosclerosis in lower limbs. Methods Data on 18 patients with 53 occluded lesions in lower limbs, treated with FFA between January 2007 and January 2008 were collected and analyzed retrospectively. Procedural success rate, early complications and continued clinical improvement were observed. Primary patency,limb salvage, and survival rates were calculated. Results one case of pseudoaneurysm occurred in the early process. Procedural success rate were different and associated with location of the lesions, and it was much lower on crural artery with occlusive lesion. Clinical success rate was 30/53. The average hospital stay was 8 days. Overall primary patency, limb salvage, and survival rates were 27/30,16/18 and 17/18 respectively, at 6 months. Conclusion PTA combined with stent implantation is safety, effective and feasible in patients with occlusive lesion in lower limb arteries.

关 键 词：下肢动脉闭塞性病变 支架 经皮球囊血管成形术 

分 类 号：R543.5[医药卫生—心血管疾病] R815[医药卫生—内科学]