超声引导介入治疗外周动脉硬化闭塞症  

Ultrasound-guided Interventional Therapy for Peripheral Arteriosclerosis Obliterans

作　　者：吴中俭 崔世军[1] 郭连瑞[1] 齐立行[1] 佟铸[1] 杨盛家[1] 谷涌泉[1] Wu Zhongjian;Cui Shijun;Guo Lianrui(Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院血管外科,北京100053

出　　处：《中国微创外科杂志》2022年第5期425-430,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：国家重点研发项目(2021YFC2500500)。

摘　　要：目的探讨超声引导介入治疗外周动脉硬化闭塞症的安全性和可行性。方法2019年3月~2020年5月,对6例合并肾功能不全(4例)或造影剂过敏(2例)的外周动脉硬化闭塞症,在超声引导下行介入治疗,包括股浅动脉斑块旋切联合药物涂层球囊(drug coated balloon,DCB)扩张1例,股浅动脉狭窄DCB扩张1例,股浅动脉闭塞Rotarex血栓抽吸联合DCB扩张1例,股浅动脉狭窄球囊扩张、支架置入1例,髂动脉狭窄球囊扩张、支架置入1例,移植肾动脉狭窄支架内球囊扩张1例。结果6例手术均完成,其中2例使用5 ml造影剂辅助,无手术并发症。术后肾功能无恶化。5例下肢动脉病变者术后第2日踝肱指数较术前明显改善(0.46±0.22 vs.0.72±0.27,配对t检验,t=-4.125,P=0.015)。结论超声引导外周动脉介入治疗可以安全进行。Objective To explore the safety and possibility of ultrasound-guided interventional therapy for peripheral arteriosclerosis obliterans.Methods From March 2019 to May 2020,6 patients with peripheral arteriosclerosis obliterans complicated with renal insufficiency(4 cases)or contrast medium allergy(2 cases)were treated by ultrasound-guided interventional therapy,including 1 case of directional atherectomy combined with drug coated balloon for severe stenosis of femoral artery,1 case of drug coated balloon dilation for superficial femoral artery stenosis,1 case of Rotarex thrombus aspiration combined with drug coated balloon dilation,1 case of femoral artery balloon expansion and stent placement,1 case of iliac artery balloon expansion and stent placement,and 1 case of balloon expansion inside scaffold in the transplant renal artery.Results The operations were accomplished in all the 6 cases.The operations in 2 cases were assisted with 5 ml contrast medium.None of the cases got postoperative complications or deterioration of renal function.The ankle brachial index in 5 patients with lower extremity arterial disease was significantly improved on the second day after operation(0.46±0.22 vs.0.72±0.27,paired t test,t=-4.125,P=0.015).Conclusion Ultrasound-guided peripheral arterial interventional therapy can be carried out safely.

关 键 词：超声引导 介入治疗 动脉硬化 

分 类 号：R54[医药卫生—心血管疾病]