药物涂层球囊与金属裸支架治疗下肢动脉硬化闭塞症效果和安全性对比  

Drug-coated balloon versus bare metal stent for the treatment of atherosclerotic occlusion of lower extremities: comparison of clinical efficacy and safety

作　　者：王鹏[1] 陈晓伟 包晗 张艳君[1] 黄媛丹 徐克[1] WANG Peng;CHEN Xiaowei;BAO Han;ZHANG Yanjun;HUANG Yuandan;XU Ke

机构地区：[1]中国医科大学附属第一医院放射科

出　　处：《介入放射学杂志》2019年第12期1176-1180,共5页Journal of Interventional Radiology

摘　　要：目的探讨国产紫杉醇药物涂层球囊(DCB)与金属裸支架(BMS)治疗下肢动脉硬化闭塞症(ASO)的效果和安全性差异,为下肢ASO治疗决策提供临床依据。方法采用回顾性临床对照研究方法收集79例泛大西洋学会联盟(TASC)ⅡA^C型股-腘动脉ASO患者,根据治疗方法不同分为DCB组(n=41)和BMS组(n=38),分析对比两组患者术前、术中资料,术后随访1、3、6、12个月。结果两组患者一般临床资料和靶病变程度差异均无统计学意义(P>0.05)。DCB组与BMS组术后1个月患肢踝-肱指数(ABI)差异无统计学意义(0.79±0.21对0.84±0.20,P=0.369),术后12个月一期通畅率差异无统计学意义[92.7%(38/41)对94.7%(36/38),P=0.863]。随访期间BMS组出现1例严重不良事件(血管内支架断裂),两组均无截肢和治疗相关死亡。结论国产紫杉醇DCB治疗股-腘动脉ASO效果良好,与BMS临床疗效和安全性相比无明显差异。临床决策中DCB是一重要选择。Objective To explore the differences in curative effect and safety between domestic paclitaxel-coated balloon(DCB)and bare metal stent(BMS)in treating atherosclerotic occlusion(ASO)of lower extremities,and to provide clinical basis for formulating treatment scheme for ASO of lower extremities.Methods Using retrospective clinical control study method,a total of 79 patients with TASC Ⅱ type A-C femoral-popliteal ASO were collected.According to the treatment methods,the patients were divided into DCB group(n=41,receiving drug-coated balloon treatment)and BMS group(n=38,receiving metal stent implantation).The preoperative and intraoperative data of the two groups were analyzed and compared,and the patients were periodically followed up at one,3,6 and 12 months after treatment.Results No statistically significant differences in the general clinical data and the degree of target lesions existed between the two groups(P>0.05).One month after treatment,the difference in ankle brachial index(ABI)between the two groups was not statistically significant[(0.79±0.21)versus(0.84±0.20),P=0.369].Twelve months after treatment,the difference in primary patency rate between the two groups was not statistically significant[92.7%(38/41)versus 94.7%(36/38),P=0.863].During the follow-up period,serious adverse event(endovascular stent rupture)occurred in one patient of BMS group,and no amputation or treatment-related death occurred in both groups.Conclusion For the treatment of femoral-popliteal ASO,domestic DCB has good curative effect,and in aspect of clinical efficacy and safety no significant difference exist between DCB and BMS.DCB is an useful choice in clinical decision-making for the treatment of ASO.

关 键 词：下肢 动脉硬化闭塞症 药物涂层球囊 金属裸支架 疗效 安全性 

分 类 号：R722.12[医药卫生—儿科]