导管溶栓联合药涂球囊扩张术治疗股浅动脉支架再狭窄的临床观察  

Efficacy and safety of catheter-directed thrombolysis combined with drug-coated balloon for treating superficial femoral artery intra-stent restenosis

作　　者：蒋俊[1] 李俊杰[1] 柏丈勇 蒲晓龙 刘曙民 冯建新[1] JIANG Jun;LI Junjie;BAI Zhangyong;PU Xiaolong;LIU Shumin;FENG Jianxin(Department of Interventional Radiology,the People's Hospital of Baoji,Baoji,Shaanxi Province721000,China)

机构地区：[1]宝鸡市人民医院介入科,陕西宝鸡721000

出　　处：《实用放射学杂志》2022年第7期1166-1170,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81972811)。

摘　　要：目的比较导管溶栓(CDT)联合药涂球囊扩张术(DCB)和传统球囊扩张术(CBA)治疗股浅动脉(SFA)支架内再狭窄(ISR)的临床疗效和安全性。方法纳入资料齐全的SFA-ISR患者95例,其中接受CDT+DCB联合治疗的患者50例,接受单纯CBA治疗的患者45例。使用Student-t及χ^(2)检验分别分析计量及计数资料。比较2组患者的术后踝肱指数(ABI)、行走受损问卷(WIQ)行走距离、截肢率、一期通畅率及围手术期并发症等指标。结果CDT+DCB组的ABI改善情况、WIQ距离、一期通畅率和1年内截肢率显著优于单纯CBA组(P<0.05)。穿刺口并发症2组无显著差别(P>0.05),CDT+DCB组的术中远端血管栓塞和严重肢体缺血发生率显著低于CBA组(P<0.05)。结论CDT+DCB相比CBA在治疗SFA-ISR中,具有更优的近中期治疗效果,及更低的栓塞事件和严重缺血发生率。Objective To compare the clinical efficacy and safety of catheter-directed thrombolysis(CDT)and drug-coated balloon(DCB)in combination for superficial femoral artery(SFA)intra-stent restenosis(ISR)with conventional balloon angioplasty(CBA).Methods A total of 95 patients with complete information of the SFA-ISR were included.50 patients received CDT+DCB,and the other 45 patients received CBA.Student-t and χ^(2) tests were used to analyze the measurement and counting data The post-operative ankle brachial index(ABI),walking impairment questionnaire(WIQ)walking distance,amputation rate,primary patency rate and perioperative complications were compared between two groups.Results The improvement of ABI and WIQ distance,primary patency rate and 1-year amputation rate of CDT+DCB group were significantly better than those of CBA group(P<0.05).There was no significant difference in puncture complications between two groups(P>0.05).The incidence rates of distal vascular embolism and severe limb ischemia of CDT+DCB group were significantly lower than those of CBA group(P<0.05).Conclusion Compared with CBA for treating SFA-ISR,CDT+DCB has a better near-and medium-term therapeutic effect and lower incidence rates of embolization and limb severe ischemia.

关 键 词：支架内再狭窄 股浅动脉 导管溶栓 药涂球囊扩张术 

分 类 号：R815[医药卫生—放射医学] R543.5[医药卫生—临床医学]