定向斑块切除联合药物涂层球囊对比普通球囊联合金属裸支架治疗股腘动脉病变的队列研究  

Comparative study of directional atherectomy combined with drug-coated balloon and conventional balloon angioplasty with bare metal stent for the treatment of femoropopliteal artery lesions

作　　者：李杨 齐一侠 宁雅婵 张帆 刘端 郭建明 佟铸 郭连瑞 谷涌泉 Li Yang;Qi Yixia;Ning Yachan;Zhang Fan;Liu Duan;Guo Jianming;Tong Zhu;Guo Lianrui;Gu Yongquan(Department of Vascular Surgery,Xuanwu Hospital,Capital Medical University,Vascular Surgery Institute of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院血管外科首都医科大学血管外科研究所首都医科大学血管外科学系,北京100053

出　　处：《中国血管外科杂志(电子版)》2025年第1期39-45,共7页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家重点研发计划(2021YFC2500504,2022YFC3602400,2022YFC3602404)。

摘　　要：目的评价定向斑块切除(directional atherectomy,DA)联合药物涂层球囊(drug-coated balloon,DCB)对比普通球囊(conventional balloon,CB)联合金属裸支架(bare-mental stent,BMS)治疗股腘动脉病变的安全性和有效性。方法采用回顾性队列研究分析2016年1月至2019年3月首都医科大学宣武医院接受完成DA联合DCB和CB联合BMS治疗的107例股腘动脉病变患者临床资料。结果DA联合DCB组患者51例,CB联合BMS组56例,两组的主要基线资料差异无统计学意义(P>0.05)。手术技术成功率100%,DA联合DCB组、CB联合BMS组12个月的一期通畅率分别为83.72%、70.00%,差异无统计学意义(P=0.101);24个月一期通畅率分别为73.17%、52.17%,差异有统计学意义(P=0.047)。DA联合DCB组、CB联合BMS组12个月和24个月的免于临床症状驱动靶病变血管重建率分别为97.56%、92.50%和91.43%、78.79%,差异无统计学意义(12个月:P=0.335;24个月:P=0.166)。DA联合DCB组和CB联合BMS组的主要不良事件发生率分别为8.51%和17.65%,差异无统计学意义(P=0.239)。结论DA联合DCB治疗股腘动脉病变的中期疗效优于CB联合BMS。Objective To evaluate the safety and efficacy of directional atherectomy(DA)combined with drug-coated balloon(DCB)compared to conventional balloon(CB)with bare-metal stent(BMS)in the treatment of femoropopliteal artery lesions.Methods A retrospective cohort study was conducted to analyze the clinical data of 107 patients with femoropopliteal artery lesions who underwent either DA combined with DCB or CB combined with BMS treatment at Xuanwu Hospital,Capital Medical University from January 2016 to March 2019.Results The DA combined with DCB group included 51 patients,and the CB combined with BMS group included 56 patients.There were no statistically significant differences in the main baseline characteristics between the two groups(P>0.05).The technical success rate of the procedures was 100%.The 12-month primary patency rates were 83.72%in the DA combined with DCB group and 70.00%in the CB combined with BMS group,with no statistically significant difference(P=0.101).The 24-month primary patency rates were 73.17%and 52.17%,respectively,with a statistically significant difference(P=0.047).The rates of freedom from clinically driven target lesion revascularization at 12 and 24 months were 97.56%and 91.43%in the DA combined with DCB group,and 92.50%and 78.79%in the CB combined with BMS group,with no statistically significant differences(12 months:P=0.335;24 months:P=0.166).The incidence of major adverse events was 8.51%in the DA combined with DCB group and 17.65%in the CB combined with BMS group,with no statistically significant difference(P=0.239).Conclusion The mid-term efficacy of DA combined with DCB in the treatment of femoropopliteal artery lesions are superior to CB combined with BMS.

关 键 词：定向斑块切除 药物涂层球囊 金属裸支架 股腘动脉 

分 类 号：R654.4[医药卫生—外科学]