微创动脉内膜剥脱联合球囊扩张术在TASC C/D型股腘动脉闭塞症的临床研究

目的探索微创动脉内膜剥脱联合球囊扩张术在TASC C/D型股腘动脉闭塞症的手术疗效和相关并发症。方法回顾2013年3月至2016年11月我院诊断为TASC C/D型股动脉闭塞症患者46例,其中以行微创动脉内膜剥脱联合球囊扩张术治疗的22例患者为研究组,以腔内球囊扩张加支架置入术24例患者为对照组。观察并记录术中手术成功率及手术时间、ABI、血管通畅率、再次手术率、再次手术成功率、死亡率及截肢率等。结果研究组与对照组对比:手术成功率(100%vs75%,P0.05),手术时间(118.2±18.5min VS 136.4±39.2min,P0.05),差值有统计学意义,说明研究组手术成功率更高,手术耗时更短。术后ABI及技术成功率比较差异无统计学意义(P0.05)。术后随访1年,术后6个月和1年通畅率比较,差值均无统计学意义。术后1年内研究组患者和对照组再次手术率、截肢率和死亡率对比均无统计学意义。结论微创动脉内膜剥脱联合球囊扩张术治疗TASC C/D型股腘动脉闭塞患者手术成功率相对较高,手术时间较腔内治疗短,疗效确切。随访1年内,和腔内治疗疗效相当。考虑随访时间短,其远期疗效对比有待考证。     

股腘动脉TASCⅡC/D型病变腔内重建与旁路手术的疗效对比

目的:比较腔内重建与旁路手术两种方法治疗股腘动脉TASCⅡ( trans-atlantic inter-society consensusⅡ) C/D型病变的近、远期疗效. 方法:回顾性分析2002年1月至2012年12月北京大学第三医院介入血管外科收治的103例(119条患肢)股腘动脉TASCⅡ C/D型病变患者的临床资料,其中71条患肢应用球囊扩张和/或支架植入重建股浅动脉血运(腔内组) ,48条患肢行旁路转流术(旁路组). 比较两组患者围手术期并发症发生率、死亡率、住院时间、近远期疗效、再手术率、1 ~10 年通畅率及保肢率. 结果:与腔内组相比,旁路组住院时间更长[(13. 2 ± 4. 7) d vs. (6. 5 ± 3. 1) d,P<0. 001],并发症发生率和再手术率更高(10. 4% vs. 1. 4%, P=0. 039;58. 3%vs. 31. 0%,P=0. 003),近期显效率更高(25. 0% vs. 9. 9%,P=0. 027),远期恶化率更高[37. 5% vs. 18. 3%,P=0. 019],1~10年一期及二期累积通畅率更高(P=0. 001, P=0. 001). 两组近期及远期总有效率相当(89. 6% vs. 84. 5%, P=0. 426, 45. 8% vs. 56. 3%, P=0. 260);保肢率差异无统计学意义(83. 3% vs. 94. 4%, P=0. 051). 结论:腔内治疗对于股腘动脉TASC ⅡC/D型病变是一种安全、有效、微创的治疗方法.     

股动脉病变球囊扩张与支架植入的疗效对比研究

目的：比较单纯经皮腔内血管成形术（percutaneous transluminal angioplasty，PTA）与PTA联合支架植入两种方法治疗股腘动脉病变的近、远期疗效。方法：回顾性分析2003年1月至12月北京大学第三医院收治的95例（107条患肢）股腘动脉病变患者的临床资料，根据患者接受的治疗方式，将其分为PTA组（单纯PTA，60条患肢）和支架组（PTA联合支架植入，47条患肢），采用门诊和电话问诊方式随访。结果：PTA组60 条患肢中22条为单纯股腘动脉病变，13条合并髂动脉病变，17条合并膝下动脉病变，8条合并髂动脉及膝下动脉病变；支架组47条患肢中18条为单纯股腘动脉病变，8条合并髂动脉病变，15条合并膝下动脉病变，6条合并髂动脉及膝下动脉病变。两组患者的年龄、性别构成、合并症、治疗前踝肱指数及Rutherford分级差异均无统计学意义（P>0.05），但PTA组中泛大西洋协作组（Trans-Atlantic Inter-Society Consensus，TASC）C/D级所占比例低于支架组（58.3% vs.76.6%，P=0.047）。PTA组和支架组随访时间分别48.0（5.0，108.0）个月和40.0（3.0，96.0）个月，差异无统计学意义（P=0.064）。支架组治疗费用及近期总有效率明显高于PTA组［（33 882.7±8 695.6）元vs.（17 754.8±3 654.2）元， P<0.001；93.6% vs.80.0%，P=0.044］；近期显效率尽管略高于PTA组，但差异无统计学意义（31.9% vs.21.7%，P=0.231）；近期有效率以及并发症发生率与PTA组相比差异无统计学意义（58.3% vs. 58.3%， P=0.724；1.7% vs.2.1%，P=1.000）；两组均无近期恶化及围术期死亡病例。支架组远期显效率低于PTA组，恶化率高于PTA组，但差异均无统计学意义（8.5% vs. 15.0%，P=0.381；14.9% vs.5.0%，P=0.081）；两组远期总有效率、累积保肢率及再手术率差异无统计学意义（66.0% vs. 66.7%，P=0.939；94.7% vs.94.1%，P=0.884；31.9% vs. 31.7%，P=1.000）。两组1~10年一期及二期累积通畅率差异无统计学意义（P=0.837，P=0.622）。进一步分组比较表明，支架组TASC A/B级和C/D级患者近期显效率、总有效率及远期恶化率均高于PTA组，但差异均无统计学意义（P>0.05）。结论：对于动脉硬化闭塞症导致的股腘动脉病变，支架植入虽提高了近期疗效，但远期疗效和保肢率方面与单纯PTA无显著差异，且治疗费用增加。     

老年人TASCⅡC-D型下肢动脉闭塞的腔内治疗及预后相关因素分析

目的探讨老年人TASC II C-D型下肢ASO的血管腔内治疗效果及影响预后的相关因素。方法分析2011年1月至2015年6月收治的51例老年人TASC 11 C-D型下肢ASO患者接受血管腔内治疗的临床资料,对患者术后6、12和24个月的临床症状、通畅率进行分析。结果成功开通患者股腘动脉48条,成功率92.3%。38例患者获得随访3~48月。患者术后一周ABI(0.77±0.12)与术前(0.34±0.13)比较,差异具有统计学意义(P0.05)。对术后影响通畅率的因素进行分析:女性患者通畅率高于男性患者(P0.05),高龄患者通畅率较高(P0.05),吸烟及营养不良可降低患者通畅率(P0.05)。结论血管腔内治疗对于老年TASCⅡC-D型ASO患者是一种安全有效的方法。性别、年龄、吸烟、营养情况影响患者治疗疗效。     

流出道对糖尿病患者股腘动脉腔内成形术预后的影响

目的应用北美血管外科协会(Society for Vascular Surgery,SVS)流出道评分标准,研究流出道病变评分对糖尿病合并下肢动脉硬化闭塞症患者行股腘动脉腔内成形术后一期通畅率的影响。方法回顾性分析进行股腘动脉腔内介入治疗的糖尿病性下肢动脉硬化闭塞症患者41条患肢,记录内科疾病、股腘动脉病变、泛大西洋学会联盟(Trans-Atlantic Inter-SocietyConsensus,TASC)Ⅱ分级情况、介入治疗完成时的流出道SVS评分以及术后30 d合并症。随访并通过Kplan-Meier方法计算一期通畅率,应用Cox回归模型分析影响预后的危险因素。结果 22条患肢股腘动脉一期植入金属裸支架,成功进行膝下流出道血管球囊扩张。本组病例术后流出道评分及分布:1～3分3条,3.5～5分7条,5.5～7分15条,7.5～10分16条,术后流出道评分中位数为7分。随访时间最短1个月,最长48个月,中位随访时间12个月,随访率为95.1%。股腘动脉腔内成形术后一期通畅率在1、3、6个月,1、2、3年分别为:95.0%,92.5%,92.5%,77.4%,65.3%和45.5%。术后流出道评分的分值高低对术后一期通畅率具有显著影响(RR=1.857,P=0.003,95%CI:1.230～2.806)。结论股腘动脉流出道条件差是影响其腔内成形术预后的主要危险因素,术后流出道SVS评分的分值越高,一期通畅率越低。     

糖尿病性膝以下动脉病变单纯球囊扩张治疗半年随访观察

目的:观察糖尿病膝以下动脉病变患者单纯球囊扩张治疗半年内的疗效. 方法: 对31例糖尿病膝以下动脉病变患者38条患肢进行下肢血管球囊扩张治疗,观察术前、术后1 wk, 1和6 mo下肢疼痛程度、足背皮温、踝臂指数(ABI)及血管超声的变化. 结果: ①膝以下多支动脉病变患肢占63.16%,动脉病变以重度为主;②术后1 wk,1和6 mo的疗效有效率分别为84.21%,89.47%,75.67%,ABI、足背皮温较术前增加,下肢血管超声示局部血管内径无明显差异,股动脉、股浅动脉、腘动脉和足背动脉的血流速度均较术前明显增加(P<0.05). 但术后6 mo的上述指标较术后1 wk和1 mo有所回落. ③半年肢体存活率为100%. 结论: 单纯球囊扩张治疗对糖尿病膝以下动脉病变患肢有良好疗效,下肢动脉血供、ABI、足背皮温、间歇跛行以及静息痛均有所好转,半年病残率为0.     

经皮血管腔内成型术治疗下肢动脉硬化闭塞症的临床研究

目的探讨经皮穿刺血管腔内成型术(percutaneous transluminal angioplasty,PTA)治疗下肢动脉硬化闭塞症(ather-oselerosis obliterans,ASO)的安全性、有效性及临床疗效。方法回顾性分析2006年6月～2008年7月我院收治并行PTA术的ASO患者46例,其中TASCⅡC型24例,TASCⅡD型22例。评价患者术前术后踝肱指数(ABI)、累计通畅率和围手术期并发症。结果 6例患者发生围手术期并发症,发生率为13.0%;术后ABI较术前明显升高(0.36±0.15 vs 0.75±0.75,t=10.93,P<0.0001);40例患者完成12个月随访,术后12个月累计通畅率为87.5%;TASCⅡC与TASCⅡD两组患者比较随访期间再发动脉闭塞风险差异无统计学意义(HR=1.13,P=0.85);结论 PTA治疗下肢动脉硬化闭塞症安全且临床疗效确切。     

丹红注射液联合前列地尔治疗2型糖尿病下肢血管病变的临床疗效分析

目的:分析丹红注射液联合前列地尔治疗2型糖尿病下肢血管病变的临床效果。方法:选取2015年3月-2017年2月本院收治2型糖尿病下肢血管病变80例患者,按随机数字表法分为对照组和研究组,每组40例。对照组接受丹红注射液治疗,研究组接受前列地尔联合丹红注射液治疗,观察并比较两组的疗效、下肢每分钟血流量与内径值。结果:研究组的总有效率为92.50%,高于对照组的77.50%,差异有统计学意义(P0.05)。两组患者治疗前后的DBP、SBP、糖化血红蛋白、踝肱指数比较,差异均无统计学意义(P0.05);治疗前,两组的TNF-α、肱踝脉搏传导速度比较,差异均无统计学意义(P0.05),治疗后,研究组均低于对照组,差异均有统计学意义(P0.05)。治疗前,两组患者下肢动脉各指标比较,差异均无统计学意义(P0.05);治疗后,研究组胫后动脉、股动脉、足背动脉、腘动脉的每分钟血流量均大于对照组,差异均有统计学意义(P0.05);两组胫后动脉、股动脉、足背动脉、腘动脉的内径比较,差异均无统计学意义(P0.05)。结论:建议临床治疗2型糖尿病下肢血管病变可联合丹红注射液和前列地尔,其疗效突出,症状改善明显,且可提升ABI和足背动脉流速等,避免血管病变进一步发展,值得临床推广。     

CDT 对支架血管成形术治疗TASCⅡD 级AIOD 患者 近中期有效性与安全性的影响

目的:探讨导管定向溶栓（CDT）减容治疗对支架血管成形术治疗TASC Ⅱ D 级主髂动脉闭塞症（AIOD）近中期有效性与 安全性的影响。方法: 回顾性分析2015—2020 年天津医科大学总医院血管外科腔内治疗的105 例（158 条患肢）TASCⅡ D 级AIOD患者的临床资料。依照不同术式分为溶栓组（n=13）、支架组（n=53）及联合组（n=39）进行对比分析。比较术中射线暴露 时间、支架置入长度、围手术期出血事件发生率、术后随访期间一期通畅率、免于不良事件发生率、各时段ABI、Rutherford 分级 改善程度等。结果:共100 例患者（148 条患肢）成功开通靶病变,患肢手术成功率93.6%（148/158）。52例经CDT治疗的患者围 术期间未见CDT 相关出血事件发生,其中41 例（78.8%）患者TASCⅡ分级降低,52 例经CDT 治疗的患者中有39 例联合金属 裸支架置入,置入支架长度明显短于原始病变长度（t=5.019,P=0.000）。联合组射线暴露时间少于支架组（P=0.000）。36 个月随 访时支架组及联合组一期通畅率优于溶栓组（Log-Rank=5.409、6.748,P=0.020、0.034）,60个月随访时联合组一期通畅率优于溶 栓组（Log-Rank=4.414,P=0.036）。不同手术方式患者在随访36、60个月时免于不良事件发生率差异无统计学意义（P>0.05）。与 术前ABI值相比,术后各组ABI值均提升（P<0.05）,随访6 个月时联合组和支架组ABI 值优于溶栓组（P=0.014、0.046）,联合组 与支架组相比差异无统计学意义（P=0.564）;各组Rutherford 分级均较术前降低（P=0.000）,联合组和支架组比溶栓组术后 Rutherford分级改善程度更优（P=0.001、P=0.021）,支架组与联合组比较差异无统计学意义（P=0.296）。结论:CDT辅助支架血管 成形术治疗TASCⅡ D级AIOD患者临床效果好安全性高。     

硫辛酸联合丹参治疗糖尿病下肢血管病变54例

目的:探讨硫辛酸与丹参治疗糖尿病下肢血管病变的临床疗效。方法:选择2型糖尿病合并下肢血管病变患者103例,根据不同药物治疗分为研究组54例和对照组49例。对照组均予糖尿病宣教、饮食控制、丹参等常规治疗,研究组在此基础上予联合硫辛酸治疗,治疗21d为一个疗程。比较两组治疗前后WIQ量表评分、症状评分、足背动脉血流量、ABI、患肢血流动力学指标。结果:治疗前,两组WIQ量表评分、症状评分、足背动脉血流量、ABI、患肢血管内径、平均血流速度、血流峰值等血流动力学指标差异无统计学意义(P>0.05);治疗后,两组WIQ量表评分升高,症状评分降低,足背动脉血流量、ABI及血流动力学指标均增加,组内与组间差异均有统计学意义。结论:硫辛酸联合丹参治疗糖尿病下肢血管病变可显著改善患者行走功能、临床症状及血流动力学指标,增加肢体血流量,收到较好疗效。     

Endovascular interventions for TransAtlantic InterSociety Consensus II C and D femoropopliteal lesions

Background  Peripheral artery disease accounts for more than 400 000 hospitalizations in the USA and results in symptoms ranging from claudication to gangrene. Recent advances in endovascular techniques have led to a more aggressive approach for treating peripheral artery disease. The aim of this retrospective study was to evaluate the outcomes of endovascular interventions on TransAtlantic InterSociety Consensus (TASC) II C and D femoropopliteal occlusive disease.

Methods  Data for all patients undergoing endovascular interventions for femoropopliteal occlusive disease from December 2007 through December 2010 were reviewed. Demographic data, risk factor data, preprocedural and postprocedural ankle-brachial indices, technical success rates, and complication rates were obtained. Primary, assisted primary, and secondary patency were determined by Kaplan-Meier survival analysis. Univariate and multivariate analyses were performed to identify factors adversely affecting primary patency.

Results  The study group included 52 TASC II C and 106 TASC II D limbs in 126 patients (mean age, (68.0±18.0) years). The technical success rate was 91.1%. Complications occurred in 19 limbs (12.0%), including 8 (5.1%) major complications. The mean follow-up period was (17.6±5.1) months (range, 12.0–48.0 months). Primary patency rates at 1, 2, 3, and 4 years were 95%, 78%, 74%, and 74% in TASC II C lesions and 89%, 62%, 52%, and 52% in TASC II D lesions, respectively. Secondary patency rates at 1, 2, 3, and 4 years were 97%, 94%, 94%, and 94% in TASC II C lesions and 97%, 95%, 83%, and 83% in TASC II D lesions, respectively. It is significantly different between primary patency rates (P <0.05) but not secondary patency rates of TASC II C and D groups (P >0.05). Predictors of restenosis/occlusion included hyperlipidemia, lesion length, and popliteal artery involvement.

Conclusions  Endovascular treatment of TASC II C and D femoropopliteal artery occlusion has a high technical success rate with favorable mid-term secondary patency rate. Hyperlipidemia, lesion length, and popliteal artery involvement were independent risk factors for in-stent restenosis.

     

Open and Endovascular Treatment of Trans-Atlantic Inter-Society Consensus II D Aortoiliac Occlusive Lesions: What Determines the Rate of Restenosis?

Background:

Open surgery is the preferred approach for the treatment of type D lesions according to the Trans-Atlantic Inter-Society Consensus (TASC) II guideline, but endovascular solutions also appear to be a valid option in selected patients. The study aimed to identify the risk factors of restenosis after open and endovascular reconstruction of symptomatic TASC II D aortoiliac occlusive lesions (AIOLs).

Methods:

Fifty-six patients (82 limbs) who underwent open repair and endovascular treatment (ET) for symptomatic TASC ΙΙ D AIOLs between March 2005 and December 2012 were retrospectively reviewed. Baseline characteristics, preoperative and postoperative imaging, and operation procedure reports were reviewed and analyzed. Restenosis after revascularization was assessed by duplex ultrasound or computed tomography angiogram. Kaplan-Meier survival analysis, Log-rank test, and multivariate Cox regression were used to evaluate the relevance between risk factors and patency.

Results:

The mean duration of follow-up was 42.8 ± 23.5 months (ranging from 3 to 90 months). Primary patency rates at 1-, 3-, 5-, and 7-year were 93.6%, 89.3%, 87.0%, and 70.3%, respectively. Restenosis after revascularization occurred in 11 limbs. Kaplan-Meier survival analysis and the Log-rank test revealed that diabetes, Rutherford classification ≥5^th and concurrent femoropopliteal TASC II type C/D lesions were significantly related to the duration of primary patency. According to the result of Cox regression, diabetes and femoropopliteal TASC ΙΙ type C/D lesions were identified as the risk factors for restenosis after revascularization.

Conclusion:

This study demonstrated that diabetes and femoropopliteal TASC ΙΙ type C/D lesions are risk factors associated with restenosis after open and ET of TASC II D AIOLs.     

经胭动脉入路逆行内膜下血管成形术治疗股浅动脉长段硬化性闭塞症临床对照研究

目的探讨经胭动脉人路逆行内膜下血管成形术治疗股浅动脉长段硬化性闭塞症的可行性和近期效果。方法回顾性分析17例因股浅动脉及胭动脉近端完全闭塞接受经胭动脉入路逆行内膜下廊管成形术／支架置人术的患者,并选择同期24例因相似病变行常规人路内膜下血管成形术／支架置人术成功的患者与之相对照,两组TASC11分类构成比无统计学差异（P〉0．05）。分析比较两组技术成功率、临床疗效、术中术后并发症发生情况。结果两组技术即时成功率均为100％。观察组术后6个月的初次通畅率为94．7％（16／17）;12个月时初次通畅率为76．5％（13／17）,再次通畅率100％。并发症（3例,17．6％）主要有胭动脉穿刺点假性动脉瘤,股动脉穿刺点出血,肢体远端动脉急性栓塞,根据情况给予了相应处理。ABI指数从术前的（0．43±0．23）上升至（0．89±0．26）（出院前）,6个月（0．86±0．25）及12个月（0．81±0．23）时保持改善状态（P〈0．01）。对照组术后6个月的初次通畅率为91．7％（22／24）;12个月时初次通畅率为75．0％（18／24）,再次通畅率100％。并发症2例（8．3％）,均为术后当晚股动脉穿刺点出血,重新加压包扎处理。ABI指数从术前的（0．55±0．31）上升至（0．90±0．23）（出院前）,6个月（0．88±0．21）及12个月（0．85±0．26）时保持改善状态（P〈0．01）。两组间术后通畅率、ABI差异无统计学差异（P〉0．05）。结论对于长段股浅动脉／胭动脉近端闭塞性病变,在腔内顺行开通失败的情况下运用经胴动脉入路逆行内膜下血管成形／支架置入术是一种安全有效的补救措施。     

腔内支架成形术治疗髂股动脉长段闭塞的临床疗效观察

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（0．7±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。     

Long-term results of extensive aortoiliac occlusive disease (EAIOD) treated by endovascular therapy and risk factors for loss of primary patency

Background:Although endovascular therapy has been widely used for focal aortoiliac occlusive disease (AIOD), its performance for extensive AIOD (EAIOD) is not fully evaluated. We aimed to demonstrate the long-term results of EAIOD treated by endovascular therapy and to identify the potential risk factors for the loss of primary patency.Methods:Between January 2008 and June 2018, patients with a clinical diagnosis of the 2007 TransAtlantic Inter-Society Consensus II (TASC II) C and D AIOD lesions who underwent endovascular treatment in our institution were enrolled. Demographic, diagnosis, procedure characteristics, and follow-up information were reviewed. Univariate analysis was used to identify the correlation between the variables and the primary patency. A multivariate logistic regression model was used to identify the independent risk factors associated with primary patency. Five- and 10-year primary and secondary patency, as well as survival rates, were calculated by Kaplan-Meier analysis.Results:A total of 148 patients underwent endovascular treatment in our center. Of these, 39.2% were classified as having TASC II C lesions and 60.8% as having TASC II D lesions. The technical success rate was 88.5%. The mean follow-up time was 79.2 ± 29.2 months. Primary and secondary patency was 82.1% and 89.4% at 5 years, and 74.8% and 83.1% at 10 years, respectively. The 5-year survival rate was 84.2%. Compared with patients without loss of primary patency, patients with this condition showed significant differences in age, TASC II classification, infrainguinal lesions, critical limb ischemia (CLI), and smoking. Multivariate logistic regression analysis showed age <61 years (adjusted odds ratio [aOR]: 6.47; 95% CI: 1.47–28.36; P = 0.01), CLI (aOR: 7.81; 95% CI: 1.92–31.89; P = 0.04), and smoking (aOR: 10.15; 95% CI: 2.79–36.90; P < 0.01) were independent risk factors for the loss of primary patency.Conclusion:Endovascular therapy was an effective treatment for EAIOD with encouraging patency and survival rate. Age <61 years, CLI, and smoking were independent risk factors for the loss of primary patency.     

血管腔内介入治疗下肢动脉硬化闭塞症48例临床分析

目的探讨血管腔内介入治疗下肢动脉硬化闭塞症的临床疗效。方法选择收治的下肢动脉硬化闭塞症患者48例(60条肢体),观察血管腔内介入治疗术中血管再通及治疗前后症状改善情况。结果 48例患者60条肢体中共成功46例52条,成功率86.7%,死亡2例。46例患者术后随访3～24个月,显效25例(54.3%),稳定15例(32.6%),进展6例(13.1%)。术后踝肱指数为0.68～1.22(0.37±0.17),显著高于手术前的0.11～0.98(0.37±0.19),差异有统计学意义(P<0.01)。结论血管腔内介入治疗可有效改善动脉硬化闭塞症患者下肢缺血症状。     

动脉粥样硬化所致下肢动脉狭窄或闭塞患者的血管腔内治疗及疗效观察

目的探讨动脉粥样硬化所致下肢动脉狭窄或闭塞血管腔内治疗的临床可行性及应用价值。方法 2009年1月至2013年12月我科收治经CT血管造影（CTA）和数字减影血管造影（DSA）证实为动脉粥样硬化性下肢动脉狭窄或闭塞患者36例（42条患肢）,将行经皮腔内球囊扩张血管成形术（PTA）或/和支架植入术治疗。按照Fontaine分型治疗后临床症状改善1级或1级以上为临床成功,PTA后血管残余狭窄小于30%为技术成功。通过术后临床症状改善和CTA/MRA随访来评价治疗效果。结果 PTA技术成功率为95.2%（40/42）,1条技术不成功,1例术后合并动脉血栓,无血管夹层形成。39条肢体症状改善明显,2条无明显改善,踝肱指数从（0.50±0.11）至（0.82±0.15）。术后随访6个月Fontaine分型提高1、2、3级的患者分别为23例、13例和4例（40条患肢）。随访3~15个月,1条股动脉在12个月再次闭塞,1条胫后动脉术后8月再次闭塞,通畅率为92.8%。结论动脉粥样硬化所致下肢动脉狭窄或闭塞腔内介入治疗是安全,有效的,其有助于改善下肢血运,提高通畅率,改善患者生存质量,提高中长期保肢率。