锁骨下动脉完全闭塞的腔内治疗:单中心回顾性研究  

Endovascular treatment of total subclavian artery occlusion:A single-center retrospective study

作　　者：杨心志 牛国晨[1] 李鹏宇 姚子平 张碧辉[1] 闫子光[1] 杨敏[1] Yang Xinzhi;Niu Guochen;Li Pengyu;Yao Ziping;Zhang Bihui;Yan Ziguang;Yang Min(Department of Interventional Radiology and Vascular Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院介入血管外科,北京100034

出　　处：《中国血管外科杂志（电子版）》2024年第1期64-67,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨腔内治疗锁骨下动脉完全闭塞的有效性和远期通畅率。方法回顾性收集2018年6月至2023年6月北京大学第一医院38例行腔内治疗的锁骨下动脉完全闭塞患者临床资料,分析患者的手术成功率、并发症、症状缓解率和随访通畅率。结果技术成功率为92.1%(35/38),其中顺行及逆行再通的成功率分别为78.9%(30/38)和62.5%(5/8)。病变近端残端形态分型平钝型开通成功率比鸟嘴型更低(66.6%比94.1%,P=0.039)。症状缓解率为93.5%(29/31),无围手术期并发症发生。患者术后随访6~68个月,中位随访时间38个月,6例患者出现再狭窄,Kaplan-Meier分析显示术后5年通畅率为77.4%,未发现锁骨下动脉闭塞患者远期通畅率的独立预后因素。结论腔内治疗锁骨下动脉完全闭塞安全有效,远期通畅率较高。Objective To explore the clinical efficacy and long-term patency rate of endovascular treatment of total subclavian artery occlusion.Methods The clinical data of 38 patients with total subclavian artery occlusion undergoing endovascular treatment at Peking University First Hospital from June 2018 to June 2023 were collected retrospectively.The technical success rate,complications,symptom remission rate and follow-up patency rate of the patients were analyzed.Results The technical success rate was 92.1%(35/38),and the success rates of antegrade and retrograde recanalization were 78.9%(30/38)and 62.5%(5/8)respectively.According to the morphology of the proximal stump of the lesion,the obtuse type has a lower opening success rate than that of the beak type(66.6%vs 94.1%,P=0.039).The symptom relief rate was 93.5%(29/31),and no perioperative complications occurred.Patients were followed up for 6 to 68 months after surgery,with a median follow-up time of 38 months.Six patients developed restenosis.Kaplan-Meier analysis showed that the 5-year postoperative patency rate was 77.4%.No independent prognostic factor of long-term patency was found in patients with subclavian artery occlusion.Conclusion Endovascular treatment for total subclavian artery occlusion is safe and effective,which offers satisfactory long-term patency rate.

关 键 词：动脉闭塞性疾病 锁骨下动脉 腔内治疗 支架 

分 类 号：R654.3[医药卫生—外科学]