TASCCD型下肢动脉硬化闭塞症的腔内治疗  

Endovascular intervention therapy for Transatlantic Inter Society Consensus type C and type D lower extremity arteriosclerosis obliterans

作　　者：温志国[1] 杜丽苹[1] 李文明[1] 李彦州[1] 李晓健[1] 赵松峰[1] 胡灵[1] 梁德安[1] 

机构地区：[1]郑州大学附属洛阳市中心医院血管外科,471009

出　　处：《中华普通外科杂志》2014年第1期29-31,共3页Chinese Journal of General Surgery

摘　　要：目的总结泛大西洋协作组织（Trans．AtlanticInter—SocietyConsensus，TASC）新版动脉疾病治疗指南下肢动脉硬化闭塞症分型中C、D型病变腔内治疗经验。方法回顾性分析2011年1月至2012年12月收治68例（71条肢体）下肢动脉硬化闭塞症患者临床资料。男47例，女21例；年龄55—84岁，平均（69±7）岁；病变范围：主髂动脉病变15条肢体，股浅、胭动脉病变45条肢体，髂股胭动脉多节段病变11条肢体；病变分型：TASCC级病变49条肢体；TASCD级病变22条肢体；所有患者均接受腔内治疗。结果手术成功率94．4％（67／71）。68例患者术后63例获得随访，5例失访，随访率92．6％。随访3—26个月，平均（12±6）个月，随访期内踝关节以上截肢5例，总保肢率92．9％，死亡6例，死亡率8．8％。结论对于下肢动脉硬化闭塞症TASCC、D型病变，腔内治疗仍有较高的手术成功率和保肢率。Objective To evaluate the endovascular treatment of TASC I1 type C and D lesions in the lower limbs. Methods This is a retrospective study on the clinical data of 68 lower extremity atherosclerosis cases （71 limbs） from January 2011 to December 2012. There were 47 males, 21 females, age from 55 to 84. There were 15 limbs with aortoiliac lesions, 45 limbs with superficial femoral artery or popliteal artery lesions, 11 limbs with multi-segment iliofemoral popliteal artery lesions. Among those there were 49 limbs with grade C lesions and 22 limbs with grade D lesions. All the patients received endovascular treatment. Results The overall success rate was 94.4% （67/71） because treatment was discontinued in 4 patients for non tolerance. 63 patients were followed up for 3 to 26 （ 12 _＋ 6） months, with a follow-up rate of 92. 6%. Five patients received above the ankle amputation during the follow-up period. 6 patients died, mortality rate was 8.8%. Conclusions For arteriosclerosis obliterans, such as TASC grade C or D lesions, endovascular procedure still has a high success rate and good limb salvage rate.

关 键 词：闭塞性动脉硬化 血管成形术 气囊 支架 

分 类 号：R654.4[医药卫生—外科学]