腔内治疗TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血的中期疗效分析  

Medium-term efficacy analysis of endovascular treatment of TASC II C/D popliteal artery occlusion combined with severe limb ischemia

作　　者：刘鹏[1] 李开心 郑丽华[1] 贺新奇[1] 张峰[1] 彭军路[1] 张磊[1] Liu Peng;Li Kaixin;Zheng Lihua;He Xinqi;Zhang Feng;Peng Junlu;Zhang Lei(Department of Vascular Surgery,the First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China)

机构地区：[1]河北医科大学第一医院血管外科,河北石家庄050031

出　　处：《血管与腔内血管外科杂志》2023年第2期140-145,共6页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨腔内治疗对TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血患者的中期疗效。方法收集2017年10月至2019年12月于河北医科大学第一医院接受腔内治疗的60例(62条患肢)TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血患者的临床资料。观察患者的手术结果、临床成功率、技术成功率、治疗后并发症发生情况、随访情况,以及术后12、24、36个月的免于临床驱动的靶病变血运重建(fCD-TLR)情况、总保肢情况。分析TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血患者临床特征与fCD-TLR时间、保肢时间的关系。结果62条TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血患肢的临床成功率和技术成功率均为98.4%(61/62)。治疗后,支架断裂率为4.8%(3/62),支架内再狭窄或闭塞率为30.6%(19/62)。术后12、24、36个月,62条患肢的fCD-TLR率分别为72.6%(45/62)、54.8%(34/62)、41.9%(26/62),总保肢率分别为77.4%(48/62)、71.0%(44/62)、62.9%(39/62)。有无终末期肾病、是否为复杂病变、靶血管病变长度、TASCⅡ分型均与TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血患者的fCD-TLR时间有关(P﹤0.05)。有无糖尿病、有无终末期肾病、是否为复杂病变、TASCⅡ分型、是否为坏疽均与TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血患者的保肢时间有关(P﹤0.05)。结论腔内治疗对TASCⅡC/D型股腘动脉闭塞合并重度肢体缺血患者的中期疗效安全、有效,值得临床推广应用。Objective To investigate the medium-term efficacy of endovascular treatment in patients with TASC II C/D popliteal artery occlusion and severe limb ischemia.Method The clinical data of 60 patients(62 affected limbs)with TASC II C/D popliteal artery occlusion and severe limb ischemia who received endovascular treatment in the First Hospital of Hebei Medical University from October 2017 to December 2019 were collected.The surgical outcomes,clinical success rate,technical success rate,the occurrence of post-treatment complications,follow-up,and the freedom from clinically driven target lesion revascularization(fCD-TLR)and total limb salvage at 12,24,and 36 months after the surgery were observed.The relationship between the clinical features of TASC II type C/D popliteal artery occlusion and severe limb ischemia and the time of fCD-TLR and limb salvage were analyzed.Result The clinical success rate and technical success rate of 62 affected limbs of TASC II C/D popliteal artery occlusion and severe limb ischemia were 98.4%(61/62).After the treatment,the stent rupture rate was 4.8%(3/62)and the rate of stenosis or occlusion within the stent was 30.6%(19/62).The fCD-TLR rate of 62 affected limbs at 12,24,and 36 months after the surgery were 72.6%(45/62),54.8%(34/62)and 41.9%(26/62),the overall limb salvage rate were 77.4%(48/62),71.0%(44/62)and 62.9%(39/62),respectively.The presence or absence of end-stage renal disease,whether complex lesion,target vessel lesion length,and TASC II type were all related to the fCD-TLR time in patients with TASC II C/D popliteal artery occlusion and severe limb ischemia(P<0.05).The presence or absence of diabetes,end-stage renal disease,complex lesions,TASC II classification,and gangrene were all related to the limb salvage time in patients with TASC II C/D popliteal artery occlusion and severe limb ischemia(P<0.05).Conclusion The medium-term clinical results of endovascular treatment of TASC II C/D popliteal artery occlusion and severe limb ischemia are safe and effective,and are worthy

关 键 词：腔内治疗 股腘动脉闭塞 重度肢体缺血 靶病变血运重建率 保肢率 

分 类 号：R543[医药卫生—心血管疾病]