不同自膨式金属支架混合置入治疗股腘动脉硬化闭塞:生物相容性及保肢率  

Mixed implantation of different kinds of self-expending metal stents for femoropopliteal arteriosclerosis obliterans: biocompatibility and limb salvage rate

作　　者：陈彬[1] 刘军军[1] 赵宗刚[1] 李君[1] 李永欣[1] 辛海[1] 刘兵[1] 王豪夫[1] 

机构地区：[1]青岛大学附属医院血管外科,山东省青岛市266000

出　　处：《中国组织工程研究》2015年第8期1233-1238,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:支架置入治疗已成为下肢动脉硬化闭塞症TASCⅡC/D型病变的首选治疗方法,但TASCⅡC/D型股腘动脉病变较长,需要多个支架串联置入才能完全覆盖病变血管。目的:评价不同种类自膨式金属裸支架混合置入治疗长段股腘动脉硬化闭塞性病变的近、中期疗效。方法:纳入长段股腘动脉硬化闭塞性病变患者39例(40条患肢),其中男34例,女5例,年龄44-87岁,每条患肢均为1枚LifeS tent金属裸支架与其他不同种金属裸支架串联置入硬化闭塞段动脉,随访39个月,评价支架置入成功率,以及支架置入后的生物相容性、保肢率、一期与二期血管通畅率。结果与结论:40条患肢成功放置93枚支架,其中27条患肢放置了2枚支架,13条患肢放置了3枚支架;置入Life Stent支架40枚、Luminexx支架45枚、Smart支架1枚、Aurora支架2枚、Pulsar18支架2枚、Invatec支架3枚,支架置入成功率为92%。支架置入后12个月保肢率为95%,置入后24个月血管一期通畅率与二期通畅率分别为(42.0±0.1)%,(59.0±3.7)%,未发生因支架置入导致的血管严重损伤及组织病变。表明自彭式LifeS tent金属裸支架与其他不同种自彭式金属裸支架混合置入治疗下肢动脉狭窄闭塞性病变具有较高的生物相容性与保肢率,近中期临床疗效较满意。BACKGROUND：Stent implantation has become the main treatment method of Trans-Atlantic Inter-Society Consensus II （TASCII） C and D’s femoropopliteal lesions, but the lesions are always too long that we have to implant mixed stents to overlap the arteries. OBJECTIVE：To evaluate the up to mid term safety and efficacy of different self-expending metal stents for treatment of femoropopliteal arteriosclerosis obliterans. METHODS：Thirty patients with long-segmental femoropopliteal arteriosclerosis obliterans （40 affected limbs） were enroled, including 34 males and 5 females, aged 44-87 years old. Each affected limb was implanted with one LifeStent with another one or two different kinds of stents. After 39 months of folow-up, the successful stenting rate, post-implantation biocompatibility, limb salvage rate, primary and secondary patency rate were evaluated. RESULTS AND CONCLUSION： Totaly 93 stents were implanted in the 40 affected limbs, including 27 affected limbs with 2 stents and 13 affected limbs with 3 stents. There were 40 LifeStent stents, 45 Luminexx stents, 1 Smart stent, 2 Aurora stents, 2 Pulsar18 stents, and 3 Invatec stents, with a successful stenting rate of 92%. The limb salvage rate at 12 months was 95%. A 24 months after surgery, the primary and secondary patency rates were （42.0±0.1）% and （59.0±3.7）%, respectively. There was no severe complication and inhospital mortality. These findings suggest that the mixed implantation of self-expending stent implantation （LifeStent mixed with other kinds of stents） for femoropopliteal arteriosclerosis obliterans appears to be safe and efficient during the up to mid term.

关 键 词：生物材料 材料相容性 自彭式裸支架 动脉闭塞性疾病 血管成形 股腘动脉 

分 类 号：R318[医药卫生—生物医学工程]