腔内治疗在主髂动脉硬化闭塞症中的应用  

Endovascular treatment for aorto-iliac occlusive disease

作　　者：齐加新[1] 邹萍 金星[1] 张十一[1] 袁海[1] 张精勇[1] 黄俊荣[1] 张蕾[1] 

机构地区：[1]山东大学附属省立医院血管外科,山东济南250021 [2]济南国际机场急救中心,山东济南250107

出　　处：《中国普通外科杂志》2010年第6期597-601,共5页China Journal of General Surgery

基　　金：山东省自然科学基金资助项目(Y2003C06)

摘　　要：目的探讨主髂动脉硬化闭塞症腔内治疗的技术要点及其疗效。方法回顾性分析主髂动脉硬化闭塞患者113例临床资料,其中男79例,女34例,年龄45岁～81(平均62.5)岁。TASCA型42例(37.17%),B型39例(34.51%),C型患者13例(11.50%),D型患者19例(16.81%)。腔内治疗经股动脉或肱动脉入路,采用通过闭塞段、球囊扩张、支架放置及股总动脉内膜剥脱等方法进行治疗。结果 107例患者主髂动脉闭塞病变获开通,开通率为94.7%。68例患者临床症状明显改善,39例中度改善,。平均随访(26±2.3)个月(6～54个月),术后6个月,1,2年的初次通畅率分别为82.76%,76.21%,67.66%,术后6个月,1,2年的二次通畅率分别为92.31%,81.67%,73.62%。结论对于主髂动脉硬化闭塞的患者,综合应用多种方法进行腔内治疗是一项安全有效的措施,可获得满意的临床疗效。Objective To explore the effect of endovascular treatment for aorto-iliac occlusive disease （AIOD）.Methods The clinical data of 113 patients with AIOD,who underwent endovascular treatment,were retrospectively analyzed.The patients’mean age was 62.5 years （range,45 to 81 years）;79 patients （69.9%） were men and 39 women.According to the Trans Atlantic Inter-Society Consensus classfication,type A,B,C and D disease was respectively present in 37.17%,34.51%,11.50% and 16.81% of patients.With the approach from femoral artery or brachial artery,combined techniques,such as recanalization,balloon dilation,stent placement and concomitant common femoral endarterectomy,were applied in the treatment.Results Technical success was achieved in 107 patients（94.7%）.Clinical status was moderately improved in 39 cases and markedly improved in 68 cases.Mean time of follow-up was （26±2.3） months.At 6 months,primary patency of the occlusive artery was 82.76%,and secondary patency was 92.31%.At 12 months,primary patency was 76.21%and secondary patency was 81.67%.At 24 months,primary patency was 67.66% and secondary patency was 73.62%.Conclusions Combined multiple endovascular techniques are safe and effective methods in treatment of aortoiliac occlusive disease.

关 键 词：动脉闭塞性疾病/治疗 主动脉 髂动脉 血管腔内治疗 介入治疗 

分 类 号：R654.3[医药卫生—外科学]