Rotarex机械血栓清除系统对下肢动脉支架内再狭窄的早期疗效分析  

Analysis of early effect of Rotarex mechanical thrombectomy in the treatment of in-stent restenosis of lower extremity arteries

作　　者：徐一丁 罗灿华[1] 朱峥嵘[1] 邹岚[1] 邢越[1] 吴嘉瑜 曹健强[1] 谭羽灿[1] Xu Yiding;Luo Canhua;Zhu Zhengrong;Zou Lan;Xin Yue;Wu Jiayu;Cao Jianqiang;Tan Yucan(Department of Vascular Surgery,the First People's Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院血管外科,广东佛山528000

出　　处：《中国血管外科杂志（电子版）》2021年第2期121-124,129,共5页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的评估Rotarex机械血栓清除系统在下肢动脉支架内再狭窄中的早期疗效。方法回顾性分析佛山市第一人民医院2016年10月至2020年3月收治的25例下肢动脉支架内再狭窄患者临床资料。患者均行Rotarex机械血栓清除系统治疗,必要时行球囊扩张、支架植入术。结果患者均成功完成Rotarex机械抽栓治疗,技术成功率100%。16例患者针对残余狭窄辅助PTA治疗,5例行PTA联合支架植入治疗。术后ABI为0.93±0.24,较术前0.25±0.18有明显增高,差异有统计学意义(P<0.001)。临床成功率为96%(24/25),1例患者因术前缺血程度严重,术后行小腿截肢术。患者平均随访(16.7±6.4)个月,术后12个月的一期通畅率为88%(22/25)。患者在住院和随访期间无严重不良事件发生。结论Rotarex机械血栓清除系统可对下肢动脉支架内再狭窄中血栓性病变进行有效减容,是一种安全有效的方法,但常需联合PTA以获得更为满意的疗效。Objective To evaluate the early effect of Rotarex mechanical thrombectomy in the treatment of in-stent restenosis of lower extremity arteries.Methods The clinical data of 25 patients with in-stent restenosis of lower extremity arteries treated in the First People's hospital of Foshan from October 2016 to March 2020 were analyzed retrospectively.All patients were treated by Rotarex mechanical thrombectomy,combined with angioplasty and stent if necessary.Results All patients completed Rotarex mechanical thrombectomy successfully,and the technical success rate was 100%.16 cases of residual stenosis were treated with PTA and 5 cases were treated with PTA combined with stent.The ABI increased from 0.25±0.18 to 0.93±0.24 after treatment,and the difference was statistically significant(P<0.001).The clinical success rate was 96%(24/25).One patient underwent leg amputation after treatment due to severe preoperative ischemia.The mean follow-up time was(16.7±6.4)months,and the primary patency rate was 88%(22/25)at 12 months after surgery.No serious adverse events occurred during hospitalization and follow-up.Conclusion Rotarex mechanical thrombectomy is a safe and effective method for in-stent restenosis of lower extremity arteries.Adjunctive PTA is often necessary to obtain a more satisfactory effect.

关 键 词：机械血栓清除 下肢动脉 支架内再狭窄 球囊扩张 

分 类 号：R654.4[医药卫生—外科学]