长支架植入治疗股腘动脉硬化闭塞症的临床研究  

Long stent implantation for femoropopliteal arteriosclerosis obliterans

作　　者：冯海[1] 陈学明[1] 李晨宇[1] 朱仁明[1] 于宏志[1] 张喆[1] 王天佑[1] 

机构地区：[1]首都医科大学附属北京友谊医院血管外科,北京100050

出　　处：《中国普通外科杂志》2011年第12期1311-1314,共4页China Journal of General Surgery

摘　　要：目的观察长支架治疗长段或多节段股腘动脉狭窄闭塞病变的可行性及近期疗效。方法 2008年11月—2010年10月收治60例(共70条肢体)股腘动脉硬化闭塞的患者,应用长球囊对狭窄或闭塞性病变进行扩张成形后植入自膨式长支架(长度8～20 cm)治疗;对合并膝下动脉硬化闭塞者(24条肢体)同期应用DEEP球囊进行扩张成形。观察技术成功率、术中及术后并发症发生率和临床疗效。结果股腘动脉球囊扩张和长支架植入的技术成功率为94.3%(66/70条肢体);同期膝下动脉球囊扩张成功率为83.3%(20/24条肢体),其中3例胫腓干因扩张后弹性回缩各植入支架1枚。术后患者临床症状均明显改善,静息痛消失;ABI由术前0.45(0.44±0.20)提高至0.84(0.86±0.24)(P<0.01)。仅在股浅动脉扩张后局部破裂形成肌间血肿2例,未发生其他并发症。结论长支架治疗长段或多节段股腘动脉狭窄闭塞病变是一种微创、安全、近期疗效好的治疗方法,远期疗效有待进一步观察。Objective To investigate the feasibility and short-term efficacy of long stent grafting for treatment of long or multiple stenotic/occlusive lesions of femoropopliteal artery.Methods Sixty patients（70 limbs） with femoropopliteal arteriosclerosis obliterans,who were admitted to our department from November 2008 to October 2010,underwent long self-expandable stents implantation（length of 8-20 cm） following dilation angioplasty of the stenotic/occlusive lesions with a long balloon.The patients（24 limbs） who had concomitant arteriosclerosis obliterans of infrapopliteal artery underwent dilation angioplasty using DEEP balloon at the same time.The technical success rate,complication incidence during and after surgery and clinical efficacy was observed.Results The technical success rate of the balloon dilation plus long stents implantation in femoropopliteal artery was 94.3%（66/70 limbs）,and the success rate of balloon dilation in infrapopliteal artery performed at the same time was 83.3%（20/24limbs）.The patients′ clinical symptom improved and rest pain disappeared after operation.The ankle-brachial index（ABI） of the patients increased from 0.45（0.44±0.20） before operation to 0.84（0.86±0.24） after operation（P0.01）.Only two cases showed intramuscular hematoma due to local rupture of the ectopic superficial femoral artery,but no other complications occurred.Conclusions Long stents implantation is a minimally invasive,safe and effective method for treatment of long or multiple stenotic/occlusive lesions of femoropopliteal artery,but its long-term outcome needs to be further assessed.

关 键 词：动脉硬化 闭塞性/外科学 股动脉 腘动脉 血管成形术 气囊 支架 

分 类 号：R654.4[医药卫生—外科学]