探索锁骨下动脉狭窄与闭塞的介入腔内处理指征(附28例报告)  

Indication of endovascular treatment for subclavian artery stenosis for clinical study of 28 cases

作　　者：张欢[1] 张福先[1] 张昌明[1] 胡路[1] 冯亚平[1] 罗小云[1] 梁刚柱[1] 

机构地区：[1]北京世纪坛医院血管外科,北京100038

出　　处：《心肺血管病杂志》2011年第4期303-305,共3页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都医学发展基金资助项目(2007-2047)

摘　　要：目的:探讨锁骨下动脉狭窄与闭塞性疾病腔内处理的临床指征。方法:回顾性分析我院2006年10月至2010年5月间,因锁骨下动脉狭窄或闭塞而行腔内处理的患者28例,男性23例,女性5例,平均年龄(62±13.1)岁,其中动脉硬化性狭窄27例,大动脉炎病变1例,27例患者存在锁骨下动脉盗血综合征的表现,1例为冠状动脉搭桥术前乳内动脉造影中发现锁骨下动脉狭窄,患者并无症状。结果:28例患者腔内处理均获得成功,其中植入球囊扩张式支架27例,单纯扩张1例,全组无围手术期死亡病例,无重大并发症发生,1例穿刺处假性动脉瘤形成,经局部压迫后消失,手术前双上肢收缩压压力差为35～65 mmHg(1 mmHg=0.133 kPa),平均为(41±12.5)mmHg,手术后为(10±5)mmHg,平均为(12±7.3)mmHg,有显著性改善(P<0.05),25例患者随访1年期间,再狭窄1例,经再次处理后效果良好,其他患者无不良事件发生。围手术期并发症为4%,1年原发性通畅率为96%,2次通畅率100%。结论:通过科学的把握介入腔内处理指征,锁骨下动脉狭窄闭塞性疾病可以获得良好的临床效果。Objective：To investigate the indication of endovascular treatment for subclavian artery stenosis.Methods：The clinic data of 28 patients with Subclavian Artery Stenosis between 2006 and 2010 were retrospectively analyzed.There 27 cases in arteriosclerosis and 1 case in arteritis in 28 cases.27 cases have subclavian steal syndrome,1 case was found subclavian artery stenosis before coronary artery bypass grafting.Results：All cases had successfully performed PTCA and stent implantation.No severe procedure related complications were observed.The difference of the mean blood pressure decreased from（（41±12.5）mmHg（1 mmHg=0.133 kPa））preoperatively to（12±7.3） mmHg postoperatively（P0.05）.During 12 months follow-up in 25 patiants,sustained clinical improvement was seen in 24 patients and restenosis occurred in 1 patient.Peroperative Complication rate was 4%,the primary patency rate was 96% and the secondary patency rate was 100%.Conclusion：Percutaneous transluminal angioplasty is effective and safe for the treatment of subclavian artery stenosis through reasonable indications.

关 键 词：锁骨下动脉狭窄 腔内处理 指征 

分 类 号：R543[医药卫生—心血管疾病]