膝下动脉血运重建联合足底-足背弓腔内成形术治疗慢性肢体威胁性缺血合并2型足动脉弓  

Infrapopliteal arterial revascularization combined with pedal and plantar loop angioplasty for treating chronic limb-threatening ischemia complicated with type 2 pedal arch

作　　者：朱光照 纪东华[1] 李城[1] 张涛[1] 刘震 潘涛[1] ZHU Guangzhao;JI Donghua;LI Cheng;ZHANG Tao;LIU Zhen;PAN Tao(Department of Interventional Therapy,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院介入治疗科,辽宁大连116011

出　　处：《中国介入影像与治疗学》2023年第5期260-263,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察膝下动脉血运重建联合足底-足背弓腔内成形术(PPL)治疗慢性肢体威胁性缺血(CLTI)合并2型足动脉弓的效果。方法回顾性分析238例接受膝下动脉血运重建的CLTI合并2型足动脉弓患者,140例术中同时行PPL(PPL组)、98例未行PPL(非PPL组)。于治疗后1、3、6及12个月进行随访,比较2组累积创面愈合率及保肢率。结果随访期间PPL组2例截肢、8例死亡(包括1例截肢者),治疗后12个月保肢率93.57%(131/140);非PPL组11例截肢、8例死亡(包括3例截肢者),治疗后12个月保肢率83.67%(82/98);组间保肢率差异有统计学意义(χ2=6.008,P=0.014)。PPL组治疗后1、3、6及12个月累积创面愈合率分别为12.86%(18/140)、47.14%(66/140)、70.00%(98/140)及85.71%(120/140),非PPL组分别为7.14%(7/98)、37.76%(37/98)、51.02%(50/98)及78.57%(77/98);PPL组治疗后6个月累积创面愈合率高于非PPL组(P<0.05),治疗后1、3及12个月组间差异均无统计学意义(P均>0.05)。结论膝下动脉血运重建联合PPL治疗CLTI合并2型足动脉弓效果较好,可在一定程度上提高创面愈合率和保肢率。Objective To observe the effect of infrapopliteal arterial revascularization combined with pedal and plantar loop angioplasty(PPL)for treating chronic limb-threatening ischemia(CLTI)complicated with type 2 pedal arch.Methods Data of 238 CLTI complicated with type 2 pedal arch patients who underwent successfully infrapopliteal arterial revascularization were retrospectively analyzed,including 140 cases underwent simultaneously PPL(PPL group)but 98 cases did not(non-PPL group)during operation.The rate of cumulative wound healing and limb salvage at 1,3,6 and 12 months after operation were compared between groups.Results During follow-up,amputations occurred in 2 cases and 8 cases died(including 1 case of amputation)in PPL group,and the rate of limb salvage was 93.57%(131/140)at 12 months after operation.In non-PPL group,amputations occurred in 11 cases and 8 cases died(including 3 cases of amputation),with the rate of limb salvage of 83.67%(82/98)at 12 months after operation.The limb salvage rates at 12 months after operation were significantly different between groups(χ2=6.008,P=0.014).The cumulative wound healing rate of PPL group was 12.86%(18/140),47.14%(66/140),70.00%(98/140)and 85.71%(120/140)at 1,3,6 and 12 months after operation,respectively,while of non-PPL groups was 7.14%(7/98),37.76%(37/98),51.02%(50/98)and 78.57%(77/98),respectively.The cumulative wound healing rate of PPL group was higher than that of non-PPL group at 6 months after operation(P<0.05),but not at 1,3 and 12 months after operation(all P>0.05).Conclusion Infrapopliteal arterial revascularization combined with PPL was valuable for treating CLTI complicated with type 2 pedal arch,which could improve wound healing rate and limb salvage rate to a certain extent.

关 键 词：外周动脉疾病 下肢 血管成形术 球囊 腔内治疗 血运重建 

分 类 号：R543.5[医药卫生—心血管疾病] R815[医药卫生—内科学]