Rotarex血栓清除术联合药物涂层球囊治疗股腘动脉支架内再狭窄:3年随访结果分析  

Rotarex thrombectomy combined with drug-coated balloon for femoropopliteal artery in-stent restenosis:3 years follow up results

作　　者：廖传军[1] 宋盛晗[1] 张望德[1] Liao Chuanjun;Song Shenghan;Zhang Wangde(Department of Vascular Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院血管外科,100020

出　　处：《首都医科大学学报》2021年第5期836-840,共5页Journal of Capital Medical University

摘　　要：目的评估Rotarex血栓清除术联合药物涂层球囊(drug-coated balloon,DCB)治疗股腘动脉支架内再狭窄(femoropopliteal artery in-stent restenosis,FP-ISR)的有效性和安全性。方法对2016年6月至2017年7月间,接受Rotarex血栓清除术联合DCB治疗的32例FP-ISR患者,进行3年随访。研究的主要终点为术后3年的原发通畅率,免于临床驱动的靶病变再干预率(clinically-driven target lesion revascularization,CD-TLR)。次要终点包括不良事件发生率、截肢率及病死率。患者的术后功能恢复情况由步行障碍调查问卷(Walking Impairment Questionnaire,WIQ)评估。结果所有32例患者均获得了技术成功和手术成功,其中27例(84.4%)患者完成了3年的随访。术前平均踝肱指数(ankle brachial index,ABI)为0.45±0.14,3年时为0.81±0.10(P<0.05);术前WIQ评分为30.45±21.14,3年时为51.32±27.92(P<0.05)。Kaplan-Meier生存曲线结果显示,随访3年,原发通畅率为81.5%,免于CD-TLR为85.2%。结论Rotarex血栓清除术联合DCB治疗FP-ISR是安全有效的,其中长期结果令人满意。Objective To evaluate the effectiveness and safety of Rotarex thrombectomy combined with drug-coated balloon(DCB)for treatment of femoropopliteal artery in-stent restenosis(FP-ISR).Methods From June 2016 to July 2017,32 FP ISR patients received Rotarex thrombectomy combined with DCB,which were followed up for 3 years.The primary endpoint was primary patency of the target lesion and freedom from clinically-driven target lesion revascularization(CD-TLR)at 3 years.The secondary endpoint was the rate of major adverse limb events(MALE),amputation and mortality.The primary functional endpoint was assessed by Walking Impairment Questionnaire(WIQ).Results Technical and procedural success was achieved in all 32 patients,27(84.4%)patients completed 3 years follow-up.Mean ABI was 0.45±0.14 at baseline and 0.81±0.10 at 3 years(P<0.05).The WIQ score was 30.45±21.14 at baseline and 51.32±27.92 at 3 years(P<0.05).The Kaplan-Meier estimate of the primary patency rate at 3 years was 81.5%,freedom from CD-TLR rate at 3 years was 85.2%.Conclusion Rotarex thrombectomy combined with DCB for treatment of FP ISR is safe and effective,the medium and long-term results are satisfactory.

关 键 词：股腘动脉病变 支架再狭窄 Rotarex血栓清除术 药物涂层球囊 

分 类 号：R654.4[医药卫生—外科学]