周围动脉硬化闭塞性疾病腔内支架治疗  

Endovascular stenting treatment for peripheral arteriosclerosis obliterans

作　　者：张希全[1] 凌宝存[2] 朱伟[1] 潘晓琳[1] 董戈[1] 郭锋[1] 袁磊[1] 

机构地区：[1]山东淄博解放军一四八医院介入心内科,济南军区介入诊疗专科中心,255300 [2]山东淄博解放军一四八医院介入心普外科,济南军区介入诊疗专科中心,255300

出　　处：《介入放射学杂志》2009年第7期538-542,共5页Journal of Interventional Radiology

基　　金：军队“十一五”医药卫生计划课题(J115Z016)

摘　　要：目的探讨周围动脉闭塞性疾病(PAOD),腔内支架治疗临床效果和应用价值。方法1995年5月至2008年5月,161例PAOD患者经皮经腔内支架置入治疗。结果治疗成功率98.1%(158/161),127例下肢动脉硬化闭塞症(ASO)、术后踝肱指数(ABI)由术前平均0.35(0.11～0.58)增至0.87(0.67～1.06),两者比较差异有统计学意义(P<0.05)。53例髂动脉和25例锁骨下动脉,内支架置入治疗后随访3～52个月,无一例临床症状复发。45例股浅动脉中、上2/3段阻塞,29例股浅动脉下1/3段和腘动脉阻塞,内支架置入治疗后6～52个月,血流保持通畅率分别为91.1%(41/45)和79.3%(23/29);9例肱动脉阻塞,支架置入治疗后随访时间超过3年,支架腔内血流均保持通畅。结论经皮经腔内支架置入治疗PAOD是安全有效的方法,充分的局部溶栓治疗,可显著提高PTA和内支架置入的成功率,减少并发症。Objective To discuss the clinical effectiveness and application of endovascular stent placement for the treatment of peripheral arteriosclerosis obliterans. Methods During the period of May 1995 - May 2008, pereutaneous endovascular stent placement was performed in 161 patients with peripheral arteriosclerosis obliterans. The clinical effectiveness was observed and the results were statistically analyzed. Results Technical success was achieved in 158 cases （98.1%）. In 127 patients with arteriosclerosis obliterans of lower extremity, the average ankle braehial index （ABI） was significantly increased from original 0.35 （0.11 - 0,58） before procedure to 0.87 （0.67-1.06） after procedure （P 〈 0.05）. Fifty-three patients who received iliac artery stenting and 25 patients who received subclavian artery stenting were followed up for 3 - 52 months and no clinical symptoms reappeared. Six to fifty-two months after endovascular stent placement, the patent rate of blood flow in 45 patients with upper two-thirds superficial femoral arteriosclerosis obliterans and in 29 patients with lower one-third superficial femoral arteriosclerosis obliterans was 91.1% （41/45） and 79.3% （23/29）, respectively. In all nine patients with brachial arteriosclerosis obliterans who received stent placement, the blood flow kept unobstructed in a follow-up observation over three years. Conclusion Percutaneous endovascular stent placement is a safe and effective technique for the treatment of peripheral arteriosclerosis obliterans. Sufficient local thrombolysis is essential to increase the technical success rate and to reduce the complications.

关 键 词：动脉闭塞性疾病 血管成形术 内支架 介入放射学 

分 类 号：R543[医药卫生—心血管疾病]