双向内膜下血管成形术治疗下肢动脉长段闭塞  

Subintimal arterial flossing with antegrade-retrograde intervention technique using in long--segment chronic total occlusion of the lower extremity artery

作　　者：田鹏 褚永新 路国勇 冯睿[2] Tian Peng;Chu Yongxin;Lu Guoyong;Feng Rui(Department of Vascular Surgery,Huai＇an Hospital Affiliated to Xuzhou Medical University,Huai＇an 223002,China)

机构地区：[1]徐州医科大学附属淮安医院血管外科,江苏淮安223002 [2]上海第二军医大学附属长海医院血管外科

出　　处：《中华血管外科杂志》2018年第3期177-181,共5页Chinese Journal of Vascular Surgery

摘　　要：目的 探讨双向内膜下血管成形术（SAFARI）在下肢动脉长段闭塞病变中的治疗效果.方法 回顾性分析徐州医科大学附属淮安医院血管外科自2013年6月至2017年6月应用SAFARI技术治疗的36例慢性下肢动脉长段闭塞患者资料,比较手术前、后患者症状及踝肱指数（ABI）的变化.结果 全组手术技术成功率为94.4％,ABI由术前0.31±0.12提高至术后1周的0.83±0.25.32例患者获得随访,失访4例,随访时间1～37个月,平均16.8个月.1例腘及膝下动脉开通失败行股下段截肢术,1例髂动脉开通失败行股-股动脉转流术,8例患者术后出现股浅动脉支架内再狭窄,3例患者支架内再闭塞.34例手术成功患者,下肢缺血症状于术后24 h内消失或明显改善,无严重围术期并发症.结论 SAFARI是一种安全、有效的治疗下肢动脉长段闭塞病变的方法.Objective To investigate the efficacy of subintimal arterial flossing with antegrade-retrograde intervention （SAFARI） in treating long-segment occlusion of the lower extremity artery. Methods A total of 36 cases with long-segment occlusion treated by SAFARI from June 2013 to June 2017 were retrospectively studied, and the symptom and ankle brachial index （ABI） before and after operation were compared. Results Thirty-four cases were treated with SAFARI technique successfully, achieving a technique success rate of 94.4%. The mean ABI raised from 0.31±0.12 to 0.83±0.25. Thirty-two cases were followed up for 1 to 37 months （mean： 16.8 months）. One case were failed with SAFARI and treated with major amputation, 1 case treated with femoral-femoral artery bypass, re-stenosis occurred in 8 cases and in-stent stenosis occurred in 3 cases. In all 34 successful cases, the ischemic symptoms were markedly improved or disappeared.No severe complications occurred. Conclusions SAFARI is safe and effective in the treatment of long-segment occlusion of the lower extremity artery.

关 键 词：动脉硬化 闭塞性 血管成形术 放射学 介入性 

分 类 号：R65[医药卫生—外科学]