双向内膜下血管成形术在下肢动脉闭塞治疗中的应用  被引量:12

Subintimal arterial flossing with antegrade-retrograde intervention in treatment of atherosclerotic occlusion lesions of lower extremities

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作  者:张艳[1] 李承志[1] 关敏[1] 张红[1] 王晓白[1] 

机构地区:[1]暨南大学附属第一医院介入与血管外科,广东广州510632

出  处:《中国介入影像与治疗学》2013年第1期7-10,共4页Chinese Journal of Interventional Imaging and Therapy

基  金:国家"十一五"科技支撑计划课题项目(2006038073024)

摘  要:目的探讨双向内膜下血管成形术作为股动脉顺行导丝开通下肢动脉闭塞性病变失败时的补救方法的价值。方法对32例下肢动脉闭塞性病变经股动脉顺行导丝开通失败患者,采用经患侧腘动脉、胫前动脉、胫后动脉以及腓动脉逆行穿刺导丝开通闭塞血管,再行球囊扩张术(PTA)和支架植入术。结果 32例手术均获得成功,血管开通后下肢缺血症状即刻得到改善,患肢踝肱指数较术前明显增加[(0.83±0.17)vs(0.31±0.12),P<0.01],无严重围术期并发症发生。结论双向内膜下血管成形术可以作为下肢动脉闭塞性病变顺行导丝无法开通时的一种补救方法,可明显提高介入手术成功率。Objective To explore the application value of subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) in re-canalizing the occlusive artery of lower extremities when antegrade technique failed. Methods Retrograde technique was performed by puncturing the distal segment of the occlusive artery (popliteal artery, anterior tibial artery, posterior tibial artery or peroneal artery) in 32 patients with atherosclerotic occlusion of lower extremities when antegrade technique failed. Then PTA and/or stent implantation were further performed. Results Occlusive arteries were all re-canalized successfully using SAFARI. Lower limb ischemic symptoms improved immediately after re-canalization, and the ankle-brachial index significantly increased after operation compared with preoperation ([0. 83 ±0.17] vs [0. 31± 0.12], P〈0.01). No serious peri-operative complications occurred. Conclusion SAFARI can be used as a remedy to antegrade technique when the wire could not pass the conclusive lumen, which would significantly improve the success rate of interventional procedures.

关 键 词:动脉闭塞性疾病 放射学 介入性 双向内膜下血管成形 

分 类 号:R543.5[医药卫生—心血管疾病] R815[医药卫生—内科学]

 

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