主-髂动脉闭塞的介入治疗  

Interventional treatment for the occlusion of aorto-iliac arteries

作　　者：张曦彤[1] 徐克[1] 林炜[2] 钟红姗[1] 赵钟春[1] 冯博[1] 肖亮[1] 姜宏 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]吉林省白山市中心医院放射科 [3]解放军第四六三医院放射科

出　　处：《中华心血管病杂志》2003年第5期341-345,共5页Chinese Journal of Cardiology

摘　　要：目的　评价腹主动脉 髂动脉闭塞介入治疗方法和临床疗效。方法　 9例腹主动脉及髂动脉闭塞患者 ,男 6例 ,女 3例 ,年龄 36～ 6 8岁 ,平均 4 7 5岁。均为腹主动脉及双侧髂动脉受累 ,Ⅰ型病变 3例 ,Ⅱ型 6例 ,其中 2例共三支肾动脉受累。腹主动脉及髂股动脉造影后 ,经股动脉或肱动脉路径采用导丝开通、溶栓、PTA和内支架置入等多种介入方法综合治疗。 8例采用尿激酶 6 0～ 16 5万单位 (平均 110万单位 )溶栓 ,7例行PTA治疗 ,5例 (9支动脉 )行内支架治疗。结果　除 1例主、髂动脉和另 2例各一条髂动脉未获开通外 ,共计 8条腹主动脉 ,14条髂股动脉和 1条肾动脉均得以开通。 3例症状及体征部分好转 ,5例明显改善。术后平均住院时间为 11 3d。 8例随访 4～ 4 6个月 (平均 15 5个月 )症状无加重或再发。结论　多种介入方法综合应用是解决腹主 髂动脉病变的一项有效治疗手段 ,可使大部分血管闭塞得以解决。Objective To evaluate the interventional treatment and clinical effect of vascular occlusive pathological change of aorto-iliac arteries. Methods 9 cases (six male, three female) aged from 36 to 68 (mean 48.9)years old. All the cases were involved middle inferior segment of abdominal part of aorta and double iliac artery. There were 3 cases of type Ⅰ and six cases of type Ⅱ pathological changes. Among them,there were two cases whose three branches of renal arteries were involved. After angiography of abdominal part of aorta and iliac-femoral artery, we carried out canalization, thrombolysis, PTA and stent implantation by guidewire via femoral artery or humoral artery. Eight cases underwent thrombolysis with urokinese (60 000- 1 650 000 units, mean 1 100 000 units) and 7 cases underwent PTA and stent implantation(5 cases, 9 branches arteries). Results There were 3 cases failed with canalization,one case of aorta and iliac artery occlusion and two cases of iliac artery occlusion. Except that, 8 cases of abdominal part of aorta, 14 branches of iliac-femoral arteries and one case of renal artery were successed in canalization. Three cases did not receive stent implantation, their manifestations and signs became better partly, the other 5 cases improved obviously. The mean operation time was 3.2 hours. After operations, the mean time of stay in hospital was 11.3 days. Eight cases were followed-up for 4-46 (mean 15.5 )months after operation. There were no recrudescense. Conclusions Synthetical method of several interventional technique is effective for vascular pathological change of aorta-iliac artery.

关 键 词：主-髂动脉闭塞 介入治疗 疗效 血管成形术 内支架置入 尿激酶 

分 类 号：R543.5[医药卫生—心血管疾病]