老年患者TASC C、D级髂股动脉闭塞的腔内治疗  

Endovascular treatment of iliac femoral artery occlusive disease with TASC C,D lesions in elderly patients

作　　者：田磊[1] 刘希光[2] 王中华[1] 谷雨丰 杨晓冬[1] 王世华[1] 张朝军[1] 

机构地区：[1]中国人民解放军海军总医院普通外科,北京100048 [2]中国人民解放军海军413医院重症监护病房,浙江舟山316000

出　　处：《中国介入影像与治疗学》2017年第7期400-403,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：海军总医院创新培育基金(CXPY20160607)

摘　　要：目的探讨对泛大西洋协作组织(TASC)C、D级髂股动脉闭塞老年患者行腔内治疗的疗效。方法 104例老年TASC C、D级髂股动脉闭塞患者接受微创腔内介入手术,其中TASC C型73例、TASC D型31例,闭塞长度4.25~17.61cm,平均(13.46±1.24)cm。对腔内介入治疗的临床疗效、并发症、术后随访等情况进行分析。结果 94例成功开通闭塞动脉,技术成功率90.38%(94/104),其中单纯球囊扩张12例、联合支架植入92例。围手术期发生并发症8例,并发症发生率为7.69%(8/104),包括急性动脉血栓2例、穿刺处假性动脉瘤形成1例、心功能衰竭4例、对比剂肾病1例。术后7天踝肱指数由术前的0.32±0.12增至0.81±0.11(P<0.01)。术后6个月、12个月各随访78例和53例患者,通畅率分别为88.46%(69/78)、81.13%(43/53)。结论对老年TASC C、D级髂股动脉闭塞患者,微创腔内介入治疗手术成功率高,并发症少,可取得满意的临床疗效。Objective To investigate the effect of endovascular treatment in iliac femoral artery occlusive disease of Trans-Atlantic Inter-Society Consensus （TASC） C, D lesions in elderly patients. Methods Totally 104 elderly TASC C, D patients with iliac femoral artery occlusion were treated, including TASC C （n=73）, TASC D （n=31）. Occlusive length range were 4.25-17.61 cm, with an average of （13.46±1.24）cm. The curative effect, complications and following up after surgery were analyzed. Results Ninty-four patients were treated successfully, and the technical success rate was 90.38% （94/104）; 12 patients underwent balloon dilation, 92 patients underwent balloon dilation combined stent. There were 8 cases （8/104, 7.69%） with periprocedural complications, included arterial thrombosis （n=2）, pseudoaneurysm （n=1）, heart failure （n=4）, and radiographic contrast nephropathy （n=1）. Doppler ankle-brachial index increased from 0.32±0.12 to 0.81±0.11 （P〈0.01） at 1 week after treatment. The patency rates were 88.46% （69/78） and 81.13% （43/53） at 6 and 12 months followed-up respectively. Conclusion Minimally invasive endovascular treatment has high technical success rate, low complication rate, and satisfactory clinical curative effect for iliac femoral artery occlusive disease of TASC C, D lesions in elderly patients.

关 键 词：动脉硬化 髂动脉 股动脉 血管介入 老年人 

分 类 号：R543.5[医药卫生—心血管疾病] R816[医药卫生—内科学]