紫杉醇药物涂层球囊治疗下肢股腘动脉长段病变的短期疗效
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摘要
目的探究紫杉醇药物涂层球囊(DCB)治疗下肢股腘动脉长段病变的近期临床疗效。方法对本中心2016年5月至2017年2月应用DCB治疗股腘动脉长段动脉硬化闭塞症的19例患者的术前、术中临床资料及术后随访资料进行总结分析。结果 22例下肢股腘动脉长段病变患者经术前评估计划行紫杉醇DCB治疗,其中19例患者成功采用药物涂层球囊进行治疗,2例患者术中导丝经内膜下通过病变段,遂更改治疗方案行支架成形术,1例患者普通球囊扩张后出现明显影响血流动力学的夹层,亦更改治疗方案为支架成形术。术后6个月通畅率为89.5%,6个月随访期间没有患者需要再次接受手术干预,患者术后ABI较术前明显升高,平均升高0.36±0.20(P<0.05)。围术期及随访期间均未发生死亡、截肢等严重临床事件。结论 DCB治疗下肢股腘动脉长段病变可获得良好的早期疗效。
Objective To evaluate short-term effect of drug-coated balloon(DCB) in the treatment of long(Tasc C and D)femoral popliteal artery diesese. Methods Collected and analyzed the clinical data of preoperative, intraoperative and postoperative of 19 patients with arteriosclerosis obliterans of femoral popliteal artery, who were admitted to authors' s department from May 2016 to Febryary 2017. Results In all patiens planed to be treated by DCB,19 patiens were treated with DCB successfully. Two patiens were treated with stent for subintimal angioplastation and 1 patients were treated with stent for aortic dissection.The six months patency rate was 89.5% and no patient reqeired reoperation. The mean ABI was increased0.36±0.20(P<0.05). There were no severe clinical events(death or amputationion)occurred during perioperative period and follow up. Conclusion In the treatment of long femoral popliteal artery diesese, DCB provides good short-term outcome.
Objective To evaluate short-term effect of drug-coated balloon(DCB) in the treatment of long(Tasc C and D)femoral popliteal artery diesese. Methods Collected and analyzed the clinical data of preoperative, intraoperative and postoperative of 19 patients with arteriosclerosis obliterans of femoral popliteal artery, who were admitted to authors' s department from May 2016 to Febryary 2017. Results In all patiens planed to be treated by DCB,19 patiens were treated with DCB successfully. Two patiens were treated with stent for subintimal angioplastation and 1 patients were treated with stent for aortic dissection.The six months patency rate was 89.5% and no patient reqeired reoperation. The mean ABI was increased0.36±0.20(P<0.05). There were no severe clinical events(death or amputationion)occurred during perioperative period and follow up. Conclusion In the treatment of long femoral popliteal artery diesese, DCB provides good short-term outcome.
引文
[1]Authors TFM,Aboyans V,Ricco JB,et al.2017 ESCguidelines on the diagnosis and treatment of peripheral arterial diseases,in collaboration with the European Society for Vascular Surgery(ESVS)[J].Eur J Vasc Endovasc Surg,2018,55:301-302.
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[11]Lammer J,Zeller T,Hausegger KA,et al.Sustained benefit at2 years for covered stents versus bare-metal stents in long SFAlesions:the VIASTAR trial[J].Cardiovasc Intervent Radiol,2015,38:25-32.
[12]Davaine JM,Quérat J,Guyomarch B,et al.Incidence and the clinical impact of stent fractures after primary stenting for TASC C and D femoropopliteal lesions at 1 year[J].Eur JVasc Endovasc Surg,2013,46:201-212.
[13]Laird JR,Katzen BT,Scheinert D,et al.Nitinol stent implantation vs.balloon angioplasty for lesions in the superficial femoral and proximal popliteal arteries of patients with claudication:three-year follow-up from the RESILIENTrandomized trial[J].J Endovasc Ther,2012,19:1-9.
[14]Jia X,Zhang J,Zhuang B,et al.Acotec drug-coated balloon catheter:randomized,multicenter,controlled clinical study in femoropopliteal arteries:evidence from the AcoArt I Trial[J].JACC Cardiovasc Interv,2016,9:1941-1949.
[15]Cioppa A,Stabile E,Salemme L,et al.Combined use of directional atherectomy and drug-coated balloon for the endovascular treatment of common femoral artery disease:immediate and one-year outcomes[J].EuroIntervention,2017,12:1789-1794.
[16]Bosiers M,Peeters P,Tessarek J,et al.The Zilver(R)PTX(R)Single Arm Study:12-month results from the TASC C/Dlesion subgroup[J].J Cardiovasc Surg(Torino),2013,54:115-122.
[17]Zeller T,Rastan A,Macharzina R,et al.Drug-coated balloons vs.drug-eluting stents for treatment of long femoropopliteal lesions[J].J Endovasc Ther,2014,21:359-368.
[2]Chicharro-Luna E,Gracia-Vesga MA,Orozco-Beltran D.Prevalence of peripheral arterial disease and associated factors in elderly patients using an automated oscillometric device[J].Rev Enferm,2014,37:18-24.
[3]符伟国,岳嘉宁.股腘动脉段病变支架内再狭窄的腔内治疗策略分析[J].中华外科杂志,2016,54:586-590.
[4]袁时芳,崔风强,陈江浩.药物涂层球囊治疗下肢动脉缺血病变的应用现状[J/CD].中国血管外科杂志(电子版),2017,9:84-86.
[5]Abdelsalam H,Chan TY,Millen A,et al.Subintimal angioplasty for long(TASC C and D)superficial femoral artery occlusions[J].Egyptian Journal of Radiology&Nuclear Medicine,2015,46:967-975.
[6]Mohr PJ,Oyama JK,Luu JT,et al.Clinical outcomes of endovascular treatment of TASC-II C and D femoropopliteal lesions with the Viabahn endoprosthesis[J].Cardiovasc Revasc Med,2015,16:465-468.
[7]Cortese B,Berti S,Biondi-Zoccai G,et al.Drug-coated balloon treatment of coronary artery disease:a position paper of the Italian Society of Interventional Cardiology[J].Catheter Cardiovasc Interv,2014,83:427-435.
[8]Norgren L,Hiatt WR,Dormandy JA,et al.Inter-society consensus for the management of peripheral arterial disease(TASC II)[J].Eur J Vasc Endovasc Surg,2007,45:S1-S67.
[9]Iida O,Soga Y,Hirano K,et al.Long-term outcomes and risk stratification of patency following nitinol stenting in the femoropopliteal segment:retrospective multicenter analysis[J].J Endovasc Ther,2011,18:753-761.
[10]Laird JR,Katzen BT,Scheinert D,et al.Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery:twelvemonth results from the RESILIENT randomized trial[J].Circ Cardiovasc Interv,2010,3:267-276.
[11]Lammer J,Zeller T,Hausegger KA,et al.Sustained benefit at2 years for covered stents versus bare-metal stents in long SFAlesions:the VIASTAR trial[J].Cardiovasc Intervent Radiol,2015,38:25-32.
[12]Davaine JM,Quérat J,Guyomarch B,et al.Incidence and the clinical impact of stent fractures after primary stenting for TASC C and D femoropopliteal lesions at 1 year[J].Eur JVasc Endovasc Surg,2013,46:201-212.
[13]Laird JR,Katzen BT,Scheinert D,et al.Nitinol stent implantation vs.balloon angioplasty for lesions in the superficial femoral and proximal popliteal arteries of patients with claudication:three-year follow-up from the RESILIENTrandomized trial[J].J Endovasc Ther,2012,19:1-9.
[14]Jia X,Zhang J,Zhuang B,et al.Acotec drug-coated balloon catheter:randomized,multicenter,controlled clinical study in femoropopliteal arteries:evidence from the AcoArt I Trial[J].JACC Cardiovasc Interv,2016,9:1941-1949.
[15]Cioppa A,Stabile E,Salemme L,et al.Combined use of directional atherectomy and drug-coated balloon for the endovascular treatment of common femoral artery disease:immediate and one-year outcomes[J].EuroIntervention,2017,12:1789-1794.
[16]Bosiers M,Peeters P,Tessarek J,et al.The Zilver(R)PTX(R)Single Arm Study:12-month results from the TASC C/Dlesion subgroup[J].J Cardiovasc Surg(Torino),2013,54:115-122.
[17]Zeller T,Rastan A,Macharzina R,et al.Drug-coated balloons vs.drug-eluting stents for treatment of long femoropopliteal lesions[J].J Endovasc Ther,2014,21:359-368.