定向斑块旋切联合药物涂层球囊治疗股腘动脉病变进展  

Directional atherectomy combined with drug-coated balloon dilatation for femoropopliteal artery diseases: recent advances in research

作　　者：蔡志文 谷涌泉[1,2] CAI Zhiwen;GU Yongquan(Academic Department of Vascular Surgery,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院血管外科,血管外科研究所 [2]首都医科大学血管外科学系,北京100053

出　　处：《介入放射学杂志》2019年第3期301-304,共4页Journal of Interventional Radiology

基　　金：北京市医管局临床医学发展专项项目(XMLX201836);北京市医管局临床技术创新项目(XMLX201610);北京市医管局"登峰"人才计划项目(DFL20150801)

摘　　要：股腘动脉硬化闭塞症是影响人类健康的常见疾病。目前腔内治疗已成为主流术式,但术后再狭窄率仍很高。定向斑块旋切术(DA)通过斑块切除改善血管顺应性,但降低再狭窄率效果不明显。药物涂层球囊(DCB)出现为解决这一问题带来曙光,其通过承载的药物进入血管壁防止内皮细胞和平滑肌细胞增殖,从而发挥远期抗内膜增生作用。多项研究表明DCB可降低晚期管腔丢失(LLL)和再狭窄率,减少再次手术率。DA与DCB联合应用可提高药物摄取,取得较好疗效。然而目前的研究证据还不充分,仍需更多大样本多中心随机对照研究加以验证。Femoropopliteal arteriosclerosis obliteration has been a common disease affecting human health.Currently,endovascular treatment has become the mainstream of operation,but the postoprative restenosis rate is still very high.Directional atherectomy(DA)can improve blood vessel compliance by removing plaque,but it has no obvious effect in reducing the restenosis rate.The emergence of drug-coated balloon(DCB)has brought the dawn to solve this problem.Through the entry of its loaded drug into the vascular wall to prevent the proliferation of endothelial cells and smooth muscle cells,DCB exerts its long-term anti-intimal hyperplasia effect.A number of studies have shown that DCB can reduce the late lumen loss and the restenosis rate,thus decrease the re-operation rate.Combination use of DA and DCB can improve the uptake of drugs,then,better results can be expected.However,the present research results are not sufficient to support the above theoretical speculation,and large sample and more multicenter randomized controlled studies need to be done before it can be validated.

关 键 词：股腘动脉硬化闭塞症 定向斑块旋切术 药物涂层球囊 

分 类 号：R654.3[医药卫生—外科学]