两种入路治疗股浅动脉慢性闭塞性病变的疗效  

The outcome analysis of the effects of endoluminal treatment for superificial femoral artery chronic total occlusion lesions through two different approaches

作　　者：厉建林 王磊[1] 苗仁英 苗超峰[1] 陈宁恒[1] 张闯[1] 李萌[1] 张秀丽[1] 宋燕[1] 郭学利[1] LI Jianlin;WANG Lei;MIAO Renying;MIAO Chaofeng;CHEN Ningheng;ZHANG Chuang;LI Meng;ZHANG Xiuli;SONG Yan;GUO Xueli(Deparment of Vascular Sur-gery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院血管外科,郑州450052

出　　处：《实用医学杂志》2020年第23期3264-3268,共5页The Journal of Practical Medicine

摘　　要：目的观察经腘动脉入路逆行开通股浅动脉慢性闭塞性(chronic total occlusion,CTO)病变的安全性和有效性。方法回顾性分析2012年3月至2019年3月本院收治的股浅动脉CTO病变患者的病历及1年随访资料。经传统股动脉(femoral artery,FA)入路顺行开通为FA组(2265例),俯卧位经腘动脉(popliteal artery,PA)入路逆行开通为PA组(216例)。结果两组技术成功、支架置入及围手术期(30 d)不良事件(死亡、动脉夹层、远端栓塞及穿刺相关并发症)发生率差异无统计学意义。FA组CTO设备使用率、手术操作及透射时间均明显高于PA组(P<0.05)。1年随访一期通畅率、保肢生存率及主要不利于心脑血管事件(心肌梗死、脑卒中及任何原因的死亡)发生率差异均无统计学意义。结论相比传统股动脉入路经腘动脉入路治疗股浅动脉CTO病变同样安全有效,可作为股动脉入路的替代选择。Objective This study focused the safety and efficacy of popliteal artery access for retrograde recanalization of superficial femoral artery(SFA)chronic total occlusion(CTO)lesions.Methods The clinical and one year follow⁃up data of patients with SFA CTO lesions underwent endovascular recanalization in The First Affiliated Hospital of Zhengzhou University from March 2012 to March 2019 were reviewed retrospectively.The antegrade recanalization of SFA CTO through conventional contralateral femoral artery access in the supine position was selected as FA group(2265 patients).The retrograde recanalization of SFA CTO through popliteal artery access in the prone position was PA group(216 patients).Results The two groups had similar outcome of technical success rate,usage rate of stent and peri⁃operative(30 days)adverse event,which included death,arterial dissec⁃tion,distal embolization,puncture complications.FA group had obviously higher rate of CTO equipment usage and more longer procedure time and fluoroscopy time than PA group(P<0.05).There were no difference between two groups in 1⁃year primary patency,amputation⁃free survival,incidence of major adverse cardiovascular event,which consisted of myocardial infarction,stroke and death from any cause.Conclusions The recanalization of SFA CTO lesions through PA access was safe and effective comparable with conventional FA access.This technique should be considered as alternative with FA access.

关 键 词：慢性闭塞性病变 股浅动脉 股动脉入路 顺行开通 腘动脉入路 逆行开通 

分 类 号：R658.3[医药卫生—外科学]