药物涂层球囊与普通球囊治疗膝下动脉病变中短期疗效的单中心回顾性研究  

Evaluation of drug-coated balloon versus percutaneous transluminal angioplasty in the efficacy for treating infrapopliteal artery lesions in lower extremity arteriosclerosis obliterans:a single-center retrospective study

作　　者：谭家铖 张艳[1] 李承志[1] 李王海 刘玉龙[1] 韩键 林印胜 Tan Jiacheng;Zhang Yan;Li Chengzhi;Li Wanghai;Liu Yulong;Han Jian;Lin Yinsheng(Department of Interventional Vascular Surgery,The First Affiliated Hospital of Jinan University,Guangzhou 510000,China)

机构地区：[1]暨南大学附属第一医院介入血管外科,广州510000

出　　处：《中华血管外科杂志》2023年第4期343-347,共5页Chinese Journal of Vascular Surgery

摘　　要：目的评价药物涂层球囊(DCB)和普通球囊在动脉硬化闭塞症膝下动脉病变的中短期疗效及安全性。方法本研究为回顾性队列研究。回顾性分析2019年1月至2022年1月暨南大学附属第一医院介入血管外科诊断为下肢动脉硬化闭塞症且不合并腘动脉病变的膝下动脉病变患者101例(124条靶血管)的临床资料,根据治疗方式分为普通球囊组(PTA组,51例,65条靶血管)及药物涂层球囊组(DCB组,50例,59条靶血管),采用两独立样本t检验或x 2检验比较两组患者一般情况和随访期结果,采用Kaplan-Meier生存曲线分析比较两组一期通畅率。结果DCB组技术成功率为96.0%(48/50),PTA组为94.1%(48/51)。101例患者中,94例(99条靶血管)获得随访,其中DCB组45例,PTA组49例,中位随访时间为12(9,12)个月。DCB组症状改善33例(73.3%),再狭窄12例(26.7%),靶病变血运重建6例(13.3%),踝肱指数(ABI)0.72±0.11;PTA组症状改善26例(53.1%),再狭窄19例(38.9%),靶病变血运重建10例(20.0%),ABI 0.68±0.09。DCB组症状改善率和ABI优于PTA组,差异有统计学意义(χ^(2)=4.125,P=0.042;t=1.998,P=0.049)。DCB组12个月一期通畅率优于PTA组,差异有统计学意义(72.9%比43.2%,Log-rankχ^(2)=5.155,P=0.023)。结论相比于普通球囊,DCB在动脉硬化闭塞症膝下动脉病变中具有更好的中短期疗效和一致的安全性。Results Objective To evaluate the short-and mid-term efficacy and safety of drug-coated balloon(DCB)versus percutaneous transluminal angioplasty(PTA)for treating infrapopliteal artery lesions in lower extremity arteriosclerosis obliterans.MethodsThis study was a retrospective cohort study.A total of 101 patients(124 target vessels)were included in this study.They were diagnosed with lower extremity arteriosclerosis obliterans without concomitant popliteal artery lesions and underwent interventional vascular surgery at the First Affiliated Hospital of Jinan University from January 2019 to January 2022.The patients were divided into the PTA group(51 patients,65 target vessels)and the DCB group(50 patients,59 target vessels).General conditions and follow-up outcomes were analyzed using independent sample t-tests or chi-square tests.Kaplan-Meier survival curves were used to compare the primary patency rates between the two groups.ResultsThe technical success rates in the DCB group and PTA group were 96.0%(48/50)and 94.1%(48/51).Out of the 101 patients,94 cases(99 target vessels)were followed up,including 45 cases in the DCB group and 49 cases in the PTA group,for a median duration of 12(9,12)months.In the DCB group,symptom improvement was observed in 33 patients(73.3%),restenosis in 12 patients(26.7%),target vessel revascularization in 6 cases(13.3%),and ankle brachial index(ABI)was 0.72±0.11.In the PTA group,symptoms improved was observed in 26 cases(53.1%),restenosis in 19 cases(38.9%),target lesion revascularization in 10 cases(20.0%),and ABI was 0.68±0.09.The symptom improvement rate and ABI in the DCB group were better than those in the PTA group,with statistically significant differences(χ^(2)=4.125,P=0.042;t=1.998,P=0.049).The 12-month primary patency rate in the DCB group was higher than that in the PTA group with statistically significant difference(72.9%vs 43.2%,Log-rankχ^(2)=5.155,P=0.023).ConclusionCompared to conventional percutaneous transluminal angioplasty,drug-coated balloon demonstrates similar

关 键 词：下肢动脉硬化闭塞症 膝下病变 经皮血管腔内成形术 药物涂层球囊 

分 类 号：R654.4[医药卫生—外科学]