经皮血管内支架成形术治疗下肢动脉硬化性闭塞疾病  

PTAS treatment for lower extremity atherosclerotic occlusive diseases

作　　者：张希全[1] 凌宝存 朱伟[1] 潘晓琳[1] 董戈[1] 郭锋[1] 袁磊[1] 

机构地区：[1]解放军148医院介入心内科济南军区介入诊疗专科中心 [2]解放军148医院普通外科,山东淄博255300

出　　处：《中国介入影像与治疗学》2009年第4期334-337,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的评价经皮血管内支架成形术(PTAS),治疗下肢动脉硬化闭塞症(LEAOD)临床效果和应用价值。方法127例LEAOD患者接受了PTAS治疗,制订治疗成功标准并疗效随访,对术前术后踝/肱指数(ABI)统计学分析。结果全组治疗成功率97.64%(124/127),除3例LEAOD患者PTAS失败外,其余病例均成功,临床症状消失或好转,踝/肱指数(ABI)由0.37±0.15上升为0.87±0.18(P<0.05)。随访3～60个月,53例髂动脉均血流通畅,临床症状无复发;45例股浅动脉中、上2/3段阻塞和29例股浅动脉下1/3段阻塞,PTAS后6、12、36、60个月的通畅率分别为97.78%、91.11%、84.44%、75.56%及89.66%、79.31%、72.41%、65.52%。结论经皮腔内血管成形术(PTA)和支架成形术(PTAS)治疗LEAOD,可使闭塞血管得到长期的有效开通,显著提高血流动力学指标,是安全有效的治疗方法。Objective To estimate the clinical effect and application value of percutaneous transluminal angioplasty and stenting （PTAS） on patients with lower extremity atherosclerotic occlusive disease （LEAOD）. Methods Percutaneous transluminal angioplasty （PAT） and PATS were performed on 127 patients with diabetic lower limb arteriosclerosis. Results Total achievement ratio was 97.64% （124/127）. PTAS was failed in 3 patients, clinical symptoms disappeared or improved in 124 patients. The average ankle brachial index （ABI） before and after operation was 0.35 （0. 11-0.58） and 0.87 （0.67-1.06）, respectively. The difference in ABI before and after operation was significant （P〈0. 05）. During 3-60 months following-up, arteria iliaca remained open in 53 patients, and no recurrence of clinical symptom was found. At 6, 12, 36 and 60 months after operation, the encumbered superficial femoral artery kept smooth bloodstream with a proportion of 97.78%, 91.11%, 84. 44%, 75.56% in 45 patients in upper 2/3 segment and 89.66%, 79.31%, 72.41%, 65.52% in 29 patients in infer 1/3 segment, respectively. Conclusion Long-term vessel recanalization can be obtained effectively and haemodynamics index be remarkably improved with PTA and PTAS in LEAOD patients.

关 键 词：下肢动脉硬化闭塞症 血管内支架成形术 经皮 放射学 介入性 

分 类 号：R543[医药卫生—心血管疾病]