药物涂层球囊在股腘动脉支架内再狭窄治疗中的应用  

Application of drug-coated balloon in treating femoropopliteal in-stent restenosis

作　　者：刘晓哲[1] 王兵[1] 刘俊超[1] 丁语[1] 吴斐[1] 牛晓阳[1] 孙利坤 LIU Xiaozhe, WANG Bing, LIU Junchao, DING Yu, WU Fei, NIU Xiaoyang, SUN Likun(Department of Vascular Surgery, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, Chin)

机构地区：[1]郑州大学第五附属医院血管外科,450052

出　　处：《介入放射学杂志》2018年第5期410-414,共5页Journal of Interventional Radiology

基　　金：河南省高等学校重点科研项目(16B320023)

摘　　要：目的评价药物涂层球囊(DCB)与普通球囊(CB)血管成形术治疗股腘动脉支架内再狭窄(ISR)的临床效果。方法回顾性分析2016年1月至2017年1月收治的45例股腘动脉ISR患者临床资料,其中22例接受DCB治疗,23例接受CB治疗。术后3、6、12个月随访两组患者靶血管最小管腔直径(MLD)、远期管腔丢失(LLL)、一期通畅率等指标并作对比分析。结果 45例患者手术均获成功,无截肢或死亡患者,无失防。DCB组与CB组相比,靶血管一期通畅率在术后3个月差异无统计学意义(95.5%对86.9%,P>0.05),但术后6、12个月明显升高(86.4%对69.6%,P<0.05;81.8%对47.8%,P<0.05)。两组术前、术后7 d、术后6个月靶血管MLD差异均无统计学意义(P>0.05),术后12个月DCB组明显高于CB组(P<0.05);术后12个月DCB组靶血管LLL明显低于CB组(P<0.05)。结论 DCB治疗股腘动脉ISR较CB优势明显,具有较好的近中期疗效。Objective To evaluate the clinical efficacy of drug-coated balloon（DCB） angioplasty with that of conventional balloon（CB） angioplasty in treating femoropopliteal in-stent restenosis（ISR）. Methods The clinical data of 45 patients with femoropopliteal ISR, who were admitted to authors＇ hospital to receive treatment during the period from January 2016 to January 2017, were retrospectively analyzed. Of the 45 patients, DCB angioplasty was employed in 22（DCB group） and CB angioplasty was adopted in 23（CB group）. All patients of both groups were regularly followed up at 3, 6 and 12 months after angioplasty, and the minimal lumen diameter（MLD） of the target vessels, the late lumen loss（LLL）, and the primary patency rate of the target vessels were calculated, and the results were compared between the two groups. Results Percutaneous transluminal angioplasty was successfully accomplished in all 45 patients. No statistically significant difference in the 3-month primary patency rate of the target vessels existed between DCB group and CB group（95.5% vs. 86.9%, P〈0.05）, but the 6-month and 12-month primary patency rates of the target vessels in DCB group were significantly higher than those in CB group（86.4% vs. 69.6%, P〈0.05; 81.8% vs.47.8%, P〈0.05; respectively）. The differences in preoperative, 7-day and 6-month postoperative MLD of the target vessels between the two groups were not statistically significant（P〉0.05）, but the 12-month postoperative MLD in DCB group was significantly higher than that in CB group（P〈0.05）. The 12-month postoperative LLL in DCB group was significantly lower than that in CB group（P〈0.05）. Conclusion DCB angioplasty is superior to CB angioplasty in treating femoropopliteal ISR, it has satisfactory mid-term curative efficacy.（J Intervent Radiol, 2018, 27： 410-414）

关 键 词：药物涂层球囊 股腘动脉 支架内再狭窄 通畅率 

分 类 号：R528.1[医药卫生—内科学]