股深动脉开通与股浅动脉支架植入治疗下肢缺血的对照研究  

Case-control comparison of percutaneous intervention in deep femoral artery and stent implantation in superficial femoral artery for chronic critical limb ischemia

作　　者：钟红珊[1] 孟令岩[2] 徐克[1] 杨庆[3] 王颖[1] 李陇超[1] 

机构地区：[1]沈阳中国医科大学附属第一医院放射科介入病房,110001 [2]沈阳中国医科大学附属第一医院检验科,110001 [3]鞍山市中心医院普外二科

出　　处：《介入放射学杂志》2013年第4期283-287,共5页Journal of Interventional Radiology

摘　　要：目的对照研究经皮股深动脉成形术和(或)支架植入术与股浅动脉支架植入术治疗伴有股深动脉狭窄的慢性长节段股浅动脉狭窄/闭塞所致严重下肢缺血的临床疗效。方法 2009年8月至2012年8月,68例伴有股深动脉狭窄的股浅动脉长节段性闭塞(TASCⅡ分级C级)患者接受了股浅动脉支架植入术或股深动脉成形术和(或)支架植入术。对两组36例(18对)符合配对标准的患者进行了回顾性分析,比较两种疗法的疗效。研究终点为严重下肢缺血症状复发,需外科旁路手术、截肢或死亡。平均随访28个月。结果介入治疗后28个月时,两组在即刻及中远期临床疗效方面差异无统计学意义(P>0.05)。股深动脉成形和(或)支架植入组所需手术费用明显低于股浅动脉支架植入组。多变量分析证实膝下动脉流出道的通畅情况是影响预后的独立因素。结论对于伴有股深动脉严重狭窄的慢性长节段股浅动脉狭窄/闭塞所致严重下肢缺血患者,股深动脉成形和(或)支架植入术可获得与股浅动脉开通及支架植入术相似的临床疗效。Objective To compare preoperative and postoperative findings and clinical progress in patients with peripheral arterial disease due to long segmental occlusion in superficial femoral artery （SFA） with stenosis in deep femoral artery （DFA） undergoing PTA or stent implantation in DFA and conventional stent implantation in SFA. Methods Between 2009 to 2012, 68 patients with long segmental occlusion in SFA with stenosis in DFA underwent interventional procedures. A retrospective analysis of 18 matched patient pairs （interventional revascularization in DFA and stent implantation in SFA） was performed. Endpoints were in-stent stenosis, surgical operation, amputation and death. Mean length of follow up was 28 months. Results At 28 months after interventions, there was no statistically significant difference in outcome between PTA and/ or stent implantation in DFA and stent implantation in SFA. The operation expense of PTA and/or stent implantation in DFA is significantly lower than stent implantation in SFA. Preoperative patency of crural outflow arteries was an independent prognostic factor in multivariable analysis. Conclusion There were no significant outcome differences between PTA and/or stent implantation in DFA or stent implantation in SFA in patients who had interventional treatment for chronic critical limb ischemia due to long segmental occlusion in SFA with proximal stenosis or occlusion in DFA.

关 键 词：下肢缺血 股深动脉 球囊成形术 支架植入术 病例对照研究 

分 类 号：R543.5[医药卫生—心血管疾病]