腔内支架成形术治疗髂股动脉长段闭塞的临床疗效观察
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摘要
目的探讨腔内支架成形术在髂股动脉长段闭塞治疗中的可行性及临床疗效。方法回顾性分析2011年2月~2013年1月期间经CT血管造影(CT angiography,简称CTA)证实髂股动脉长段(>10cm)狭窄或闭塞的15例患者共16条患肢的介入治疗资料。髂动脉闭塞2例(2条),股浅动脉闭塞13例(14条),闭塞长度为11.2~31.8(21.4±5.8)cm。15例均行腔内球囊扩张及支架成形术。结果 15例16条患肢中有13例14条患肢闭塞动脉再通成功,14条患肢共植入支架25枚。13例患者临床症状均有不同程度好转,支架成形术后踝肱指数(ABI)由术前(0.32±0.12)升高至(0.78±0.20)。术后随访1年一期通畅率为71.4%.结论腔内支架成形术是治疗髂股动脉长段闭塞的一种创伤小、可行性强、近中期疗效好的治疗方法,可以作为髂股动脉长段闭塞的首选治疗手段。
Objective To discuss endovascular stenting in the iliac and femoral artery occlusion long feasibility and clinical efficacy of the treatment.Methods A retrospective analysis of our department from February 2011 to January 2013 by CT angiography(CT angiography,referred to as CTA) confirmed iliac and femoral arteries long segment) > 10cm) stenosis or occlusion of the 15 patients with a total of 16 limb involvement treatment data,Iliac artery occlusion in 2 cases(2 lower limbs),13 cases of femoral artery occlusion) 14 lower limbs),the mean lesion length was(21.4 ±5.8) cm range 11.2~31.8cm.Fifteen cases underwent endovascular balloon dilatation and stenting.Results Occlusive arterial recanalizalion was successed in 13 cases including 14 limb.Twenty-five stents were implanted in 14 limbs.Thirteen cases of patients underwent clinical symptoms of vaiying degrees of improvement,and stent angioplasty ankle-brachial index(ABI) increased from preoperative(0.32 ± 0.12) to(0.78 ± 0.20).The patency rate was 71.4%in patients followed up for 1 year.Conclusion Endovascular stenting is a minimally invasive treatment of arterial occlusion of the iliac and femoral length,feasible,recent mid-term efficacy of good treatment,as long iliac artery occlusion preferred method of treatment.
Objective To discuss endovascular stenting in the iliac and femoral artery occlusion long feasibility and clinical efficacy of the treatment.Methods A retrospective analysis of our department from February 2011 to January 2013 by CT angiography(CT angiography,referred to as CTA) confirmed iliac and femoral arteries long segment) > 10cm) stenosis or occlusion of the 15 patients with a total of 16 limb involvement treatment data,Iliac artery occlusion in 2 cases(2 lower limbs),13 cases of femoral artery occlusion) 14 lower limbs),the mean lesion length was(21.4 ±5.8) cm range 11.2~31.8cm.Fifteen cases underwent endovascular balloon dilatation and stenting.Results Occlusive arterial recanalizalion was successed in 13 cases including 14 limb.Twenty-five stents were implanted in 14 limbs.Thirteen cases of patients underwent clinical symptoms of vaiying degrees of improvement,and stent angioplasty ankle-brachial index(ABI) increased from preoperative(0.32 ± 0.12) to(0.78 ± 0.20).The patency rate was 71.4%in patients followed up for 1 year.Conclusion Endovascular stenting is a minimally invasive treatment of arterial occlusion of the iliac and femoral length,feasible,recent mid-term efficacy of good treatment,as long iliac artery occlusion preferred method of treatment.
引文
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[11]楼文胜,顾建平,何旭.内膜下成形术治疗股浅动脉长段闭塞[J].介入放射学杂志,2011,20(10):773~777.
[2]连耀植,杨敏.经股动脉溶栓治疗下肢动脉急性栓塞[J].汕头大学医学院学报,2004,17(1):92~93.
[3]刘巍立,李雪岩,张春秋.多节段下肢动脉硬化闭塞症介入治疗及手术治疗体会[J].临床外科杂志,2010,18(9):622~624.
[4]殷敏毅,蒋米尔,黄新天.股腘动脉慢性长段闭塞腔内治疗134例临床分析[J].临床外科杂志,2011,19(11):776~779.
[5]Schillinger M,Minar E.Endovascular stent implantation for treatment of peripheralartery disease[J].Eur J Clin Invest,2007,37:165~170.
[6]Matin EC,Katzen BT,Benenati JF,et al.Multicenter trial of walstent in the iliac and femoral arteries[J].J Vase Interv Radiol,1995,6:843~849.
[7]Murphy TP,Webb MS Lambiase RE,et al.Percutaneousrevascularization of complex iliac artery stenoses and occusions with use of Wallstents:three-year experience[J].J Vase Interv Radiol,1996,7:21~27.
[8]袁锋,梁惠民,韩萍.下肢动脉长段闭塞的腔内介入治疗[J].临床放射学杂志,2012,31(7):556~560.
[9]Cron J,Cron C,Corn JP.Aortofcmorl bypass:gold-standard or outdated[J].J Mai Vasc,2003,28:258~264.
[10]Surowiec SM,Davies MG,Eberly SW.el al:Percutaneous angioplasty and stenting of the superficial femoral artery[J].J Vasc Surg,2005,41:169~278.
[11]楼文胜,顾建平,何旭.内膜下成形术治疗股浅动脉长段闭塞[J].介入放射学杂志,2011,20(10):773~777.