自膨式金属裸支架治疗急性肱动脉损伤的临床疗效  

Clinical efficacy of self-expandable bare-metal stent placement for acute brachial artery injury

作　　者：张希全[1] 葛世堂 陈众[1] 窦树彬 董戈[1] 郭锋[1] 

机构地区：[1]中国人民解放军第一四八医院全军腔内介入诊疗中心,山东淄博255300

出　　处：《中国普通外科杂志》2017年第6期764-769,共6页China Journal of General Surgery

基　　金：军队后勤科研计划资助项目(CJN14J010)

摘　　要：目的:探讨自膨式金属裸支架治疗急性肱动脉损伤的安全性及临床效果。方法:回顾性分析18例急性肱动脉损伤患者资料。所有患者均接受急诊血管造影以明确诊断,行血管成形术及自膨式裸支架植入治疗。结果:18例急性肱动脉损伤的患者的手术技术成功率100%,平均手术时间为50(30~90)min。13例接受单层自膨式裸支架置入,5例接受双支架重叠置入术,共置入23枚自膨式裸支架,支架置入后即刻造影显示损伤肱动脉血流恢复通畅,假性动脉瘤消失,未见支架狭窄及对比剂外溢。无围手术期死亡和严重并发症发生。18例平均随访20.2个月,17例支架内血流完全通畅或轻度狭窄(未作处理),1例支架腔内狭窄>50%,行球囊扩张治疗后支架内血流恢复通畅;随访期间无支架移位、扭曲及断裂,无缺血坏死,截肢情况。结论:自膨式金属裸支架植入治疗急性肱动脉损伤是安全可行的,近中期效果满意。Objective： To investigate the safety and clinical effect of self-expandable bare-metal stent for acute brachial artery injury. Methods： The clinical data of 18 cases with acute brachial artery injury were retrospectively analyzed. All patients underwent emergency angiography for confirmation of the diagnosis, and then received angioplasty and self-expandable bare-metal stent placement. Results： The technical success rate of the endovascular procedures was 100%, and the mean operative time was 50 （30–90） min. Thirteen patients underwent single-layered stent placement and 5 patients underwent two overlapping stents insertion, with a total of 23 self-expandable bare-metal stents deployed. Angiography immediately after stent placement showed that the blood flow of the injured brachial artery was restored, pseudoaneurysms disappeared and no stent stenosis or contrast agent extravasation was observed. All the 18 patients were followed up for an average period of 20.2 months, 17 patients had complete blood flow restoration or minor stenosis （required no treatment）, while one patient developed a 〉50% in-stent stenosis, which was resolved by balloon dilation. No stent displacement, rotation or fracture was found, no ischemic necrosis occurred and no amputation surgery was needed during the follow-up period. Conclusion： Self-expandable bare stent placement is safe and effective in treatment of acute brachial artery injury, with satisfactory short- and medium-term efficacy.

关 键 词：血管系统损伤 肱动脉 支架 血管内操作 

分 类 号：R654.3[医药卫生—外科学]