远端保护装置在髂动脉闭塞病变腔内治疗中的作用
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摘要
目的探讨远端保护装置在髂动脉闭塞病变腔内治疗中的作用。方法收集2015年3月至2017年10月于首都医科大学附属北京安贞医院接受血管腔内治疗并使用远端保护装置的12例髂动脉闭塞患者的临床资料。分析远端保护装置拦截栓塞物及取栓的作用。结果所有患者均成功置入远端保护装置,拦截栓塞物10例(83.3%),并均将栓塞物拉出体外。患者术后患肢踝臂指数明显高于术前[(0.85±0.26)比(0.51±0.12)](P=0.037)。所有患者术后造影显示股腘动脉及膝下流出道均血流通畅,无栓塞征象,均无腔内治疗及远端保护装置相关并发症。所有患者随访(21±15)个月,1例术后6个月出现支架内再狭窄,行再次腔内治疗,一期通畅率为91.7%(11/12)。结论髂动脉闭塞病变腔内治疗同期使用远端保护装置安全有效,同时可将血栓取出。
Objective To investigate the effect of distal embolic protection device on endovascular treatment of iliac artery occlusion.Methods Clinical data of 12 patients with iliac artery occlusion from March 2015 to October 2017 in Beijing Anzhen Hospital, Capital Medical University were analyzed; all patients were treated with endovascular revascularization with auxiliary use of distal embolic protection device.The function of distal embolic protection device in revascularization was evaluated.Results All patients successfully completed the procedure; 10 cases of embolus(83.3%) were removed.Ankle-brachial index after operation was significantly higher than that before operation[(0.85 ±0.26)vs(0.51 ±0.12) ](P = 0.037).Postoperative angiography showed smooth blood flow in femoral-popliteal artery and outflow tract below the knee; no embolism and revascularizationassociated complication were observed.During(21 ±15) months of follow-up,stent restenosis occurred in 1 case at 6 months after operation; the primary patency rate was 91.7%(11/12).Conclusion Endovascular therapy with auxiliary use of distal embolic protection device is safe and effective in treating iliac artery occlusion.
Objective To investigate the effect of distal embolic protection device on endovascular treatment of iliac artery occlusion.Methods Clinical data of 12 patients with iliac artery occlusion from March 2015 to October 2017 in Beijing Anzhen Hospital, Capital Medical University were analyzed; all patients were treated with endovascular revascularization with auxiliary use of distal embolic protection device.The function of distal embolic protection device in revascularization was evaluated.Results All patients successfully completed the procedure; 10 cases of embolus(83.3%) were removed.Ankle-brachial index after operation was significantly higher than that before operation[(0.85 ±0.26)vs(0.51 ±0.12) ](P = 0.037).Postoperative angiography showed smooth blood flow in femoral-popliteal artery and outflow tract below the knee; no embolism and revascularizationassociated complication were observed.During(21 ±15) months of follow-up,stent restenosis occurred in 1 case at 6 months after operation; the primary patency rate was 91.7%(11/12).Conclusion Endovascular therapy with auxiliary use of distal embolic protection device is safe and effective in treating iliac artery occlusion.
引文
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[6]倪冷,刘昌伟,李拥军,等.主髂动脉闭塞腔内治疗技巧及疗效[J].血管与腔内血管外科杂志,2015,1(1):32-35.Ni L,Liu CW,Li YJ,et al.Techniques and outcomes of endovascular treatment for aortoiliac artery occlusive disease[J].Journal of Vascular and Endovascular Surgery,2015,1(1):32-35.
[7]Mwipatayi BP,Thomas S,Wong J,et al.A comparison of covered vs bare expandable stents for the treatment of aortoiliac occlusive disease[J].J Vasc Surg,2011,54(6):1561-1570.DOI:10.1016/j.jvs.2011.06.097.
[2]Mendes BC,Oderich GS,Fleming MD,et al.Clinical significance of embolic events in patients undergoing endovascular femoropopliteal interventions with or without embolic protection devices[J].J Vasc Surg,2014,59(2):359-367.el.DOI:10.1016/j.jvs.2013.07.119.
[3]Shammas NW,Dippel EJ,Coiner D,et al.Preventing lower extremity distal embolization using embolic filter protection:results of the PROTECT registry[J].J Endovasc Ther,2008,15(3):270-276.DOI:10.1583/08-2397.1.
[4]Hadidi OF,Mohammad A,Zankar A,et al.Embolic capture angioplasty in peripheral artery interventions[J].J Endovasc Ther,2012,19(5):611-616.DOI:10.1583/JEVT-12-3977MR.1.
[5]黄晓钟,张纪蔚.下肢动脉栓塞的置管溶栓治疗[J].临床外科杂志,2013,21(5):326-328.DOI:10.3969/j.issn.1005-6483.2013.05.003.Huang XZ,Zhang JW.Thrombolytic therapy with catheterization for lower extremity arterial embolization[J].Journal of Clinical Surgery,2013,21(5):326-328.DOI:10.3969/j.issn.1005-6483.2013.05.003.
[6]倪冷,刘昌伟,李拥军,等.主髂动脉闭塞腔内治疗技巧及疗效[J].血管与腔内血管外科杂志,2015,1(1):32-35.Ni L,Liu CW,Li YJ,et al.Techniques and outcomes of endovascular treatment for aortoiliac artery occlusive disease[J].Journal of Vascular and Endovascular Surgery,2015,1(1):32-35.
[7]Mwipatayi BP,Thomas S,Wong J,et al.A comparison of covered vs bare expandable stents for the treatment of aortoiliac occlusive disease[J].J Vasc Surg,2011,54(6):1561-1570.DOI:10.1016/j.jvs.2011.06.097.