26例TASC(Ⅱ)D型股动脉闭塞腔内治疗临床分析  

Clinical Analysis of Endovascular Treatment of TASC(Ⅱ) D-Type Femoral Artery Occlusion

作　　者：刘存发[1] 张秀军[1] 殷述刚[1] 李俊海[1] 黄梅[1] 曹健鹏[1] 戴兵[1] 张楠[1] 李津凯[1] 王永磊[1] 

机构地区：[1]天津市天津医院血管外科,300211

出　　处：《天津医药》2014年第8期827-829,共3页Tianjin Medical Journal

基　　金：天津卫生局科技基金(11KG142)

摘　　要：目的探讨TASC(Ⅱ)D型股动脉闭塞的腔内治疗方法及效果。方法回顾性分析2012年1月—2013年5月采用腔内治疗TASC(Ⅱ)D型股浅动脉闭塞26例(26肢)患者的临床资料。其中采用球囊扩张内支架置入13例(裸支架组,共植入支架31枚)、Silverhawk斑块旋切6例(Silverhawk斑块旋切组)、Viabahn覆膜支架2例(Viabahn覆膜支架组)。腔内手术未成功通过病变者5例给予前列地尔等扩血管药物治疗。通过手术前后踝肱指数(ABI)、螺旋CT血管成像(CTA)、数字减影血管造影(DSA)及症状改善情况来评价疗效;并于术后6个月复查CTA。结果 26例中成功开通目标动脉21例(技术成功率80.7%),造影证实血流通畅,残留狭窄小于30%,术后患肢缺血症状缓解。术后1周ABI高于术前(0.77±0.10 vs 0.43±0.15,t=7.948,P<0.05)。6个月一期通畅比例分别为裸支架组9/13,Silver-hawk斑块旋切组4/6,Viabahn覆膜支架2/2。结论腔内治疗TASC(Ⅱ)D型股动脉闭塞可提高近期通畅率,Viabahn覆膜支架是治疗的新手段。Objective To investigate methods and results of endovascular treatment in TASC （Ⅱ） D-type femoral artery occlusion. Methods From January 2012 to May 2013, 26 cases （26 branches） of superficial femoral artery occlusion with endovascular treatment of TASC （Ⅱ） D-type superficial femoral artery occlusion were retrospectively reviewed. The effi-cacy was evaluated through ABI, CTA, DSA and symptoms improved. Results 26 branches were treated with endovascular methods. Technical success rate was 80.7%（21/26）, including 13 branche with stent implantation, 6 branches with Silver-hawk atherectomy and 2 branches with Viabahn stent implantation. All patients were followed up for a mean period of （10.3 ± 1.2）months, primary patency rates at 6 months were 69.2%in stent group, 66.7%in Silverhawk atherectomy group and 100%in Viabahn stent group. Conclusion Endovascular treatment of TASC （Ⅱ） D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment.

关 键 词：股动脉闭塞 裸支架 Silverhawk斑块旋切 Viabahn覆膜支架 

分 类 号：R654.4[医药卫生—外科学]