股-腘动脉人工血管移植术后再闭塞的腔内治疗  

Endovascular treatment of arterial re-occlusive disease after femoral-popliteal artificial vascular grafting

作　　者：宋庆宏[2] 江涛[3] 粟力[1] 

机构地区：[1]天津市人民医院血管中心,300121 [2]天津中医药大学 [3]天津中医药大学中西医结合临床学院

出　　处：《中华普通外科杂志》2016年第8期647-649,共3页Chinese Journal of General Surgery

摘　　要：目的评价经皮球囊血管成形术和支架成形术两种腔内治疗方法治疗股-腘动脉人工血管移植术后再闭塞的疗效。方法回顾性分析2009年2月至2012年10月天津市人民医院血管中心收治的股-腘动脉人工血管移植术后再闭塞患者78例的临床资料．按治疗方法分为2组：吻合口球囊扩张术组和支架成形术组。应用双腔取栓导管取出人工血管近远端血栓后，据吻合口治疗情况进行分组，其中，吻合口球囊扩张术组36例，取栓后造影可见细窄血流信号，予以单纯球囊扩张；支架成形术组42例，取栓后造影未见血流通过，应用导丝及导管配合技术开通吻合口闭塞段，经球囊扩张闭塞段后置入合适口径白膨式支架。比较2组患者介入治疗术后12、36个月通畅率。结果所有患者均获随访，平均随访（48±8）个月。12个月的通畅率球囊组91．7％，支架组97．6％，差异无统计学意义（P=0．449，t=-0．761），36个月时累积通畅率球囊组33．0％，支架组59．9％，差异有统计学意义（P=0．004，t=2．959），支架组术后累积通畅率高于球囊组，差异有统计学意义（X^2=7．422，P〈0．05）。结论球囊扩张支架成形术通畅率高，对于股-腘动脉人工血管移植术后再闭塞的治疗较经皮球囊血管成形术存在优势。Objective To compare the patency rate of percutaneous balloon angioplasty or stenting for restenosis of femoral-popliteal artery artificial vascular grafting. Method 78 cases of femoral-popliteal artery artificial vascular graft postoperative occlusion patients were divided into 2 groups ： anastomotic balloon angioplasty group （36 cases ） and stent angioplasty group （42 cases ） after double-lumen catheter embolectomy. Patients in anastomotic balloon dilatation group were given balloon angioplasty only becaus fine narrow flow signals were seen in angiography. Patients in stenting group received balloon angioplasty followed by suitable caliber self-expanding stent placement. Patency rates were compared between the two groups after 12, 36 months of interventional treatment. Results The patency rate in stenting group was higher than that of pereutaneous balloon angioplasty group （X^2 = 7.422, P 〈 0. 05 ）. Conclusions Balloon stenting angioplasty had advantages of high patency rate over balloon dilatation for the treatment of postoperative occlusion of femoral-popliteal artery grafting.

关 键 词：手术后并发症 血管移植术 支架 股动脉 腘动脉 

分 类 号：R654.4[医药卫生—外科学]