腔内修复治疗创伤性腘动脉损伤临床分析  

Endovascular repair of popliteal artery injuries

作　　者：张希全[1] 葛世堂 陈众[1] 窦树彬 潘晓琳[1] ZHANG Xi-quan;GE Shi-tang;CHEN Zhong;DOU Shu-bin;PAN Xiao-lin(Department of Vascular Intervention,The 148th Hospital of Chinese People's Liberation Army,Shandong255300,China)

机构地区：[1]解放军第148医院全军腔内介入诊疗中心,山东淄博255300

出　　处：《影像诊断与介入放射学》2017年第6期461-465,共5页Diagnostic Imaging & Interventional Radiology

基　　金：军队后勤科研计划重点项目(CJN14J010)

摘　　要：目的评价创伤性腘动脉损伤的腔内修复效果和治疗经验。方法回顾性分析2010年1月～2017年2月我院收治的21例创伤性腘动脉损伤患者资料。男18例,女3例;年龄23～64岁,平均(37.8±11.9)岁。致伤原因包括交通伤9例,机器挤压伤4例,坠落伤3例,重物砸伤3例,医源性损伤1例,锐器伤1例。患者术前行彩色多普勒超声或CT血管造影显示腘动脉损伤情况,并经术中动脉造影确诊,选择覆膜支架、裸支架或裸支架辅助弹簧圈栓塞方法行腔内修复治疗。结果21例患者手术成功率100%,腔内修复治疗后立刻重建血流通道,腘动脉损伤段管腔血流通畅,破口被完全隔绝,无对比剂滞留、外溢。围手术期并发症3例,其中1例为胫后动脉穿刺点血肿,2例为术后患肢出现骨筋膜室综合征,分别给予对症处理后恢复良好。21例获随访6～50个月,平均(23.2±12.1)个月,1例支架腔内狭窄>50%,予以球囊扩张治疗后支架内血流恢复通畅;其余移植物在随访期内通畅。结论腔内修复治疗创伤性腘动脉损伤近、中期效果好,是一种安全、可行的方法。Objective To evaluate the efficacy of endovascular repair of popliteal artery injuries.Methods The clinical data of21patients(18men,3women,age range:23-64years,mean:37.8±11.9years)with popliteal artery injuries treated at our hospital from January2010to February2017were retrospectively analyzed.The types of trauma included motor vehicle accident(9),machine crush(4),fall from heights(3),impact by falling object(3),stab wound(1),and iatrogenic injury(1).Ultrasound or CT angiography was performed prior to endovascular repair using covered stent,bare-metal stent,or stent-assisted coil.Results Endovascular repair was successful on all patients with reconstruction of the blood flow channels,recovery of popliteal artery blood flow,isolation of the puncture in the artery,and no contrast extravasation.Perioperative complication included hematoma in the posterior tibial artery puncture site(1)and compartment syndrome(2)with recovery after symptomatic treatment.At6-50month follow-up(mean duration:23.2±12.1months),1patient with greater than50%stent stenosis required second balloon dilation.All other grafts remained patent.Conclusion Endovascular treatment of popliteal artery injuries is safe and effective in short-to mid-term follow-up.

关 键 词：腔内修复 腘动脉 创伤性 介入放射学 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.4[医药卫生—诊断学]