忽略股浅动脉重建与普通球囊重建治疗股浅动脉狭窄/闭塞远期疗效对照研究  

Superficial femoral artery nonrevascularization versus percutaneous common balloon angioplasty for superficial femoral artery stenosis/occlusion:comparison of long-term efficacy

作　　者：任洪成 庄金满[2] 李选[2] 李天润[2] 栾景源[2] 王昌明[2] 丁明超[1] 黄小勇 REN Hongcheng;ZHUANG Jinman;LI Xuan;LI Tianrun;LUAN Jingyuan;WANG Changming;DING Mingchao;HUANG Xiaoyong(Department of Interventional and Vascular Surgery,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]北京航天中心医院介入血管科,北京100049 [2]北京大学第三医院介入血管外科

出　　处：《介入放射学杂志》2021年第12期1224-1228,共5页Journal of Interventional Radiology

摘　　要：目的对比普通球囊重建与忽略股浅动脉重建(nSFA)方案治疗股浅动脉(SFA)病变的远期疗效、安全性和治疗费用。方法回顾性分析2014年1月至2016年4月收治的106例SFA重度狭窄/闭塞患者(115条患肢)临床资料,分为nSFA组(n=47,55条患肢)和经皮腔内血管成形术(PTA)组(n=59,60条患肢)。比较两组患者Rutherford分级改善率、生存率、保肢率以及主要不良事件发生率、治疗费用和住院时间。结果两组患者基线资料和病变特征具有可比性。nSFA组失访1例。nSFA组、PTA组随访时间分别为60(22,77)个月、60(1,76)个月。两组患者近期Rutherford分级改善率、生存率和保肢率差异均无统计学意义(P>0.05)。nSFA组患者远期Rutherford分级改善率、围手术期主要不良事件发生率、肢体相关主要不良事件发生率、治疗费用、住院时间均优于PTA组,差异有统计学意义(P<0.05)。结论SFA重度狭窄/闭塞患者nSFA治疗方案与PTA重建SFA方案相比,远期疗效和安全性较好,治疗费用较低,尤其对于膝下动脉流出道较好的SFA多节段闭塞患者。Objective To compare the long-term efficacy,safety and treatment cost of percutaneous transcatheter balloon angioplasty(PTA)with those of superficial femoral artery nonrevascularization(nSFA)therapy in treating stenosis and/or occlusion of superficial femoral artery(SFA).Methods The clinical data of 106 patients with severe stenosis and/or occlusion of SFA(115 diseased limbs in total),who were admitted to authors’hospital between January 2014 and April 2016,were retrospectively analyzed.The patients were divided into nSFA group(n=47,55 diseased limbs in total)and PTA group(n=59,60 diseased limbs in total).The improvement of Rutherford class,the survival rate,amputation-free rate,major adverse events,treatment cost and hospitalization days were compared between the two groups.Results The baseline data and lesion characteristics were comparable between the two groups.During follow-up period,one patient of nSFA group was lost in touch.The median follow-up time in the nSFA group and the PTA group was 60 months(22-77 months)and 60 months(1-76 months)respectively.No statistically significant differences in the short-term improvement rate of Rutherford class,the survival rate and amputation-free rate existed between the two groups(P>0.05).The long-term improvement rate of Rutherford class,the preoperative incidence of major adverse events,the incidence of major limb-related adverse events,the treatment cost and the hospitalization days in the nSFA group were remarkably better than those in the PTA group,the differences between the two groups were statistically significant(P<0.05).Conclusion For the treatment of severe stenosis and/or occlusion of SFA,nSFA therapeutic scheme has several advantages such as better long-term effect,reliable safety,lower medical cost when compared with PTA,and nSFA is especially suitable for patients who have multi-segmental SFA occlusion and unobstructed inferior geniculate artery.

关 键 词：忽略股浅动脉重建方案 股浅动脉 外周动脉疾病 

分 类 号：R543.5[医药卫生—心血管疾病]