主动脉狭窄和(或)闭塞性病变综合性介入治疗的临床观察  

Interventional treatment for stenosis/occlusion in aorta

作　　者：钟红珊[1] 徐克[1] 苏洪英[1] 张曦彤[1] 肖亮[1] 周玉斌[2] 冯博[2] 黄亘[3] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]中山医科大学附属第三医院放射科 [3]Cordis公司

出　　处：《中华放射学杂志》2003年第8期718-722,共5页Chinese Journal of Radiology

摘　　要：目的　对主动脉狭窄和 (或 )闭塞性病变 (ASO)的综合介入治疗进行疗效观察与评价。方法　本组 2 3例ASO(狭窄性病变 14例 ,闭塞性病变 9例 )均分别应用经皮主动脉闭塞穿通术、经导管局部溶栓术、经皮腔内血管成形术 (PTA)、血管内支架 (ES)置入术及经皮主动脉夹层内膜瓣开窗术(FIF)等进行了综合介入治疗。结果　 2 3例ASO的治疗成功率为 96.7%。其中 ,14例主动脉狭窄性病变的治疗成功率为 92 .9% (1例主动脉破裂死亡 )。 9例腹主动脉完全闭塞的治疗成功率为10 0 0 %。 2 3例ASO中行血管内支架置入术 11例 (狭窄 4例 ,闭塞 7例 ) ,成功率为 10 0 0 %。 1例主动脉夹层所致主 髂动脉狭窄行血管内支架置入术并用FIF获得成功。其余 12例仅采用局部溶栓术和(或 )PTA治疗 ,成功率为 91.7%。术后除 1例死亡外 ,其余 2 2例中 ,术后症状完全消失者 18例 ,症状改善者 4例。目前平均随访 3 1.0个月 (1～ 113个月 ) ,其中 1例于随访 48个月后失访 ;1例于治疗后 2个月因出现主动脉再狭窄及右下肢缺血坏死而截肢 ;1例于治疗后 18个月死于胸主动脉夹层破裂 ;19例随访至今 ,症状无复发。Objective To evaluate the effi cacy of interventional treatment for stenosis-occlusion in aorta (ASO). Methods Twenty-three patients with stenosis-occlusive pathological changes in aorta were included. Among them, 14 patients were with stenosis in aorta, and 9 with occlusion in aorta. They were all treated by combined interventional techniques, such as recanalization, local thrombolysis via catheter, percutaneous transluminal angioplasty (PTA), implantation of stent, and percutaneous fenestration of intimal flap (FIF). Results The universal successful rate of the 23 cases with ASO was 96.7%. Among the 9 cases with occlusive pathological changes in aorta, the successful rate of recanalization and local thrombolysis was 100 0%. 17 cases were treated with PTA after thrombolysis, the successful rate was 91 7% (one case died of rupture of aorta during the procedure). 11 ca ses were treated with implantation of stent after PTA, the successful rate was 100 0%. One case was successfully treated with FIF and implantation of stent. Among the group, one case was dead, 18 cases′ symptom disappeared, and 4 cases′ symptom was improved. All the patients were followed-up for 1-113 months (mean 31.0 months). Among them, one case was misfollowed after 48 months, one case died of combined dissected aorta rupture after 18 months. Restenosis occurred in one case. The therapy efficacy of the other cases was stable and there was no relapse. Conclusions Comprehensive application of multi-interventional techniques can obtain a satisfactory clinical effect in treating ASO.

关 键 词：主动脉狭窄性病变 主动脉闭塞性病变 介入治疗 经皮主动脉闭塞穿通术 经导管局部溶栓术 经皮腔内血管成形术 

分 类 号：R543.1[医药卫生—心血管疾病]