SilverHawk斑块切除系统在股腘动脉硬化闭塞性疾病中的应用  

The application of Silver Hawk atherectomy device in the treatment of femoropopliteal occlusive disease

作　　者：孙利坤 王兵[1] 刘俊超[1] 牛晓阳[1] 刘晓哲[1] 王梦宇 潘锦轩 

机构地区：[1]郑州大学第五附属医院血管外科,郑州市450052

出　　处：《实用医学杂志》2017年第18期3060-3063,共4页The Journal of Practical Medicine

基　　金：河南省高等学校重点科研项目(编号:16B320023);河南省医学科技攻关计划重点项目(编号:201202015)

摘　　要：目的评价Silver Hawk斑块切除系统治疗股腘动脉硬化闭塞性疾病的安全性和有效性。方法回顾性分析2012年8月至2014年6月应用Silver Hawk斑块切除系统治疗股腘动脉硬化闭塞性疾病46例(58条患肢)。其中股腘动脉狭窄病变52条患肢,病变长度(4.6±2.3)cm,狭窄程度(85.6±11.3)%,闭塞性病变6条患肢,病变长度(6.3±3.2)cm。术前Rutherford分级3~5级,踝肱指数(ankle brachialindex,ABI)0.45±0.36,术后采用血管多普勒超声、CTA、DSA对血管通畅情况进行随访评估。结果 46例(58条患肢)全部开通成功,技术成功率100%,治疗成功率93.10%。术后残余狭窄(10.3±6.2)%,ABI 1.05±0.32,与术前差异有统计学意义(t=5.83,P=0.02)。平均随访22个月,随访复查ABI 0.96±0.15,与术前比较差异有统计学意义(t=5.09,P=0.03),术后6个月、1年、2年的一期通畅率分别为94.83%、91.38%、84.48%,二期通畅率分别为98.28%、96.55%、93.10%。结论 Silver Hawk斑块切除系统治疗股腘动脉硬化闭塞性疾病安全有效,近、中期效果满意。Objective To evaluate the safety and efficacy of SilverHawk directional atherectomy device in the treatment of femoropopliteal occlusive disease. Methods From August 2012 to June 2014,46 patients （58 limbs） with femoropopliteal occlusive diseases in the treatment by SilverHawk directional atherectomy device were analyzed retrospectively . The mean lesion length and degree of diameter stenosisin the femoropopliteal stenoses （52 limbs） were （4.6 ± 2.3） cm and （85.6 ± 11.3） %.The mean lesion length in the femoropopliteal occlusions （6 limbs） was （6.3 ± 3.2） cm. Rutherford score was 3 - 5. Mean ABI was 0.45 ± 0.36. Patency was evaluated with color duplex sonography, CTA and DSA postoperatively. Results 46 patients （58 limbs） were recanalizated suc- cessfully via intraluminal approach. The overall technical success rate was 100%. The procedural success rate was 93.10%. Postoperative residual stenosis and ABI were （10.3± 6.2） % and 1.05 ±0.32, which had statistical diff erence compared with preoperative （t = 5.83, P = 0.02）. The average period of follow-up was 22 months. Mean ABI during the follow-up was 0.96± 0.15, which had statistical difference compared with preoperative （t = 5.09, P = 0.03 ）. The 6-month and 1- and 2-year primary patency rate was 94.83%, 91.38%, 84.48%, and secondary patency rate was 98.28%、96.55% 、 93.10%, respectively. Conclusion SilverHawk directional atherectomy device is safe and effective in treament offemoropopliteal occlusive disease, with satisfactory early-middle results.

关 键 词：下肢 动脉硬化闭塞 斑块切除术 股动脉 腘动脉 

分 类 号：R654.4[医药卫生—外科学]