覆膜支架重建技术腔内治疗TASCⅡC/D级主髂动脉闭塞症  

Endovascular Treatment of TASCⅡC/D Aortoiliac Occlusive Disease by Covered Endovascular Reconstruction of Aortic Bifurcation

作　　者：周东 何艳平 席宇 李丹 彭莉 ZHOU Dong;HE Yan-ping;XI Yu;LI Dan;PENG Li(DepartmentⅤof Vascular Surgery,Xiangyang No.1 People′s Hospital,Hubei University of Medicine,Xiangyang,Hubei 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院普外科五区,湖北襄阳441000

出　　处：《湖北医药学院学报》2024年第5期524-529,共6页Journal of Hubei University of Medicine

基　　金：襄阳市院级面上项目(XYY2023MSO4)。

摘　　要：目的:探讨覆膜支架重建技术(covered endovascular reconstruction of aortic bifurcation,CERAB)腔内治疗TASCⅡC/D级主髂动脉闭塞症(aortoiliac occlusive disease,AIOD)临床疗效。方法:回顾性分析我科2019年12月至2022年12月应用CERAB技术治疗的23例TASCⅡC/D级AIOD患者临床资料,观察手术疗效及随访结果。结果:23例患者均成功完成手术,成功率100%,其中一期支架植入17例,6例因继发血栓行导管接触性溶栓(catheter-directed thrombolysis,CDT)后二期支架植入,平均置管溶栓时间(24.3±3.1)h,平均尿激酶使用量(83.1±16.7)U,平均手术时间(95.7±20.1)min,平均住院时间(6.5±1.9)d。踝肱指数(ankle brachial index,ABI)术后较术前明显提高(P<0.05)。23例患者均获得随访,成功率100.0%,平均随访时间(32.9±20.5)月。随访期间无截肢、死亡病例,保肢率100%。术后3、6、12个月ABI值均较术前提高(P<0.05)。结论:CERAB技术治疗TASCⅡC/D型AIOD可获得较满意的临床效果及早中期通畅率。Objective To clarify the clinical efficacy of endovascular treatment of TASCⅡC/D aortoiliac occlusive disease(AIOD)using the covered endovascular reconstruction of aortic bifurcation(CERAB).Methods The clinical data of 23 AIOD patients admitted to the DepartmentⅤof Vascular Surgery of Xiangyang No.1 People′s Hospital from December 2019 to December 2022 were retrospectively analyzed.The surgical outcome and the follow-up results were discussed.Re⁃sults All patients successfully underwent the surgery,with a success rate of 100%.Seventeen patients received stent im⁃plantation in the first stage and 6 received stent implantation in the second stage after catheter-directed thrombolysis(CDT),with the average CDT time of(24.3±3.1)h,the average amount of urokinase being(83.1±16.7)U,the average surgical time of(95.7±20.1)min,and the average hospital stay being(6.5±1.9)d.Postoperatively,the ankle brachial index(ABI)showed an improvement compared with the preoperative value(P<0.05).All 23 cases were followed up(100%)with a median follow-up time of(32.9±20.5)months.During the follow-up period,there were no cases of ampu⁃tation or death,with a limb salvage rate of 100%.The ABI at 3,6,and 12 months after operation was all higher than that before operation(P<0.05).Conclusion CERAB has achieved satisfactory results and early to mid-stage patency in the treatment of TASCⅡC/D AIOD.

关 键 词：主髂动脉闭塞症 覆膜支架重建技术 球扩覆膜支架 腔内治疗 

分 类 号：R654.3[医药卫生—外科学]