主髂动脉闭塞的覆膜支架介入治疗  

Covered stent in endovascular treatment of aortoiliac occlusive disease

作　　者：赵俊来[1] 李伟[1] 张小明[1] 张学民[1] 蒋京军[1] 焦洋[1] 

机构地区：[1]北京大学人民医院血管外科,100044

出　　处：《中华普通外科杂志》2013年第7期507-510,共4页Chinese Journal of General Surgery

摘　　要：目的总结覆膜支架在主髂动脉闭塞介入治疗中的应用经验。方法45例主髂动脉闭塞患者，其中男37例，女8例，年龄38～94岁，平均（61±12）岁。临床表现间歇性跛行28例，静息痛11例，足趾坏疽6例。单侧髂动脉闭塞22例，一侧髂动脉闭塞合并对侧狭窄8例，主动脉及双侧髂动脉同时闭塞15例。病变长度6～18cm，平均（12±3）cm。4例在介入溶栓3d后置入覆膜支架，其余病例均一期置入覆膜支架。结果所有病例均成功完成操作，单侧放置覆膜支架19例，使用Kissing技术放置覆膜支架26例。所有病例术后下肢缺血症状均得到缓解，仅1例患者因感染最终截肢。随访6～21个月，平均（12±4）个月，除1例单侧髂动脉闭塞病例因远端流出道差于术后14个月闭塞外，其余支架均通畅，通畅率97．8％。结论使用覆膜支架介入治疗主髂动脉闭塞，效果是满意的。Objective To evaluate the use of covered stent in endovaseular treatment for aortoiliac occlusive disease. Method In this study 45 eases [ 8 women,37 men; age range, 38 - 94 years; mean age, （61 ±12） years] of aortoiliac occlusive disease were reviewed, 28 with intermittent claudication, 11 with rest pain, 6 with toe gangrene, including 22 unilateral iliac artery occlusions, 8 unilateral occlusions combined with contralateral stenosis and 15 aorto-bilateral iliac artery occlusions. 4 cases received catheter thrombolysis therapy for 3 days before stenting and the others received directly covered stent placement. Result Procedures were successful in all cases completed including 19 cases with one side covered stent and 26 cases with kissing covered stent. Limb ischemia was significantly relieved in all patients, only one case amputated because of infection. The mean follow-up period was （ 12 ±4） months （6 to 21 months）. All stents were patent except one occlusion at 14 months due to bad outflow. The primary patency was 97. 8%. Conclusions Covered stent can bring a satisfied results and outcomes in endovascular treatment of aortoiliac occlusive disease.

关 键 词：动脉闭塞性疾病 血栓溶解疗法 支架 

分 类 号：R654.2[医药卫生—外科学]