经皮腔内支架治疗锁骨下动脉闭塞的疗效评价  

Clinical effectiveness of endovascular therapy for total occlusion of the subclavian arteries

作　　者：刘亚军[1,2] 王迪[3] 赵卫东[1] 甘泉[1] 赵国珍[1] 张建[2] 

机构地区：[1]河北省秦皇岛市第一医院心血管外科,河北秦皇岛066000 [2]首都医科大学宣武医院血管外科,北京100053 [3]河北省秦皇岛市第一医院内分泌二科,河北秦皇岛066000

出　　处：《河北医科大学学报》2016年第1期9-12,共4页Journal of Hebei Medical University

基　　金：卫生部卫生行业科研专项项目(201302008)

摘　　要：目的评估支架植入术治疗锁骨下动脉近端完全闭塞的临床效果。方法锁骨下动脉完全闭塞患者67例均经皮腔内治疗,术后第3、6和12个月随访,此后每年随访1次。结果 15例患者未能成功再通。52例患者成功再通后行支架治疗,术后双上肢收缩压差明显低于术前;术后12个月通畅率为98.22%,24个月为94.31%,3年为92.17%;围手术期无死亡患者,发生手术相关并发症4例;37例应用球扩式支架患者中有5例出现>50%的症状性再狭窄。结论如果技术熟练,掌握好适应证,介入腔内重建可作为治疗锁骨下动脉闭塞病变的优选方案,若处理右侧闭塞病变则建议应用颈动脉保护伞预防远端栓塞。Objective The purpose of this study was to evaluate the effectiveness of stenting therapy for the patients with total subclavian artery occlusion.Methods A total of 67 patients had underwent endovascular therapy for the treatment of total subclavian artery occlusion.All patients were followed at 3,6,and 12 months after treatment and annually thereafter.Results 52 stents were placed.Technical failure was noted in 15 patients,while the symptoms failed to resolve in two.There were no perioperative deaths.4complications were observed.The rate of primary patency was 98.22% at 12 months,94.31% at 24 months,and 92.17% at 3years.Significant recurrent obstruction developed in five patients who used balloon-expandable stents.Conclusion When performed by skilled surgeons,endovascular therapy with stent placement can be used as a safe and effective therapy for total occlusion of the proximal subclavian artery.However,embolic protection devices should be considered during the management of right side occlusion.

关 键 词：锁骨下动脉 动脉闭塞性疾病 支架 

分 类 号：R654.4[医药卫生—外科学]