下肢动脉硬化闭塞症介入治疗及并发症分析  

Interventional treatment of lower extremity arteriosclerosis obliterans

作　　者：管强[1] 段红永[1] 梁宁[1] 杨笑非[1] 韩锋[1] 刘增庆[1] 

机构地区：[1]山西省人民医院山西医科大学附属人民医院血管外科,太原030012

出　　处：《中华普通外科杂志》2014年第3期203-206,共4页Chinese Journal of General Surgery

摘　　要：目的总结下肢动脉硬化闭塞症介入治疗临床效果，分析其主要并发症的原因及应对措施。方法回顾性分析山西省人民医院血管外科从2011年10月至2013年1月行介入治疗的下肢动脉硬化闭塞症72患者的临床资料，其中外院行下肢介入治疗而出现并发症的患者3例（1例为股浅动静脉瘘合并假性动脉瘤，2例为股浅动脉支架断裂）。按泛大西洋协作组织2007年标准分级，A级8例，B级21例，c级20例，D级22例（除外1例动静脉瘘患者）。全部患者行cT动脉成像或数字减影血管造影检查，70例行介入治疗，2例支架断裂者行髂外一股浅动脉人工血管搭桥术。结果70例介入治疗技术成功率为100％，2例搭桥者术后患者症状消失。介入治疗中，1例髂动脉破裂，1例患者出现远端动脉穿孔，3例远端动脉栓塞。68例患者获得随访，随访率为94．44％，随访时间为3-15个月，平均（9±4）个月。结论介入治疗的近期效果良好。要把握介入治疗的适应证，对C、D级病变细心操作，可减少并发症的发生。Objective To summarize the clinical efficacy of interventional treatment for lower extremity arteriosclerosis obliterans and its complications. Methods We analyzed sixty-nine patients with lower extremities arteriosclerosis obliterans undergoing interventional treatment from October 2011 to January 2013. During the same period, three patients were referred to us who suffered from the complications of interventional treatment. In these patients, eight were TASC Ⅱ A type, twenty-one were TASC II B, twenty TASC Ⅱ C, and twenty-two TASCⅡ D lesions. All patients received CTA or DSA. Seventy patients were treated by interventional treatment, and two who had fractured stent underwent external iliacsuperficial femoral artery bypass grafting using artificial grafts. Results The technique success rate was 100%. The symptoms disappeared after surgery. During interventional treatment, one iliac artery ruptured, one patient suffered from arterial perforation and three patients suffered from distal embolization. Sixty-eight patients were followed-up for 9± 4 months. Conclusions Endovascular treatment has good early clinical efficacy. In order to reduce the incidence of complications, indication of interventional treatment should be controlled strictly and manipulation should be careful.

关 键 词：动脉闭塞性疾病 手术后并发症 下肢 支架 

分 类 号：R543.5[医药卫生—心血管疾病]