TASC-D型髂动脉病变的腔内治疗

目的 探讨对泛大西洋协作组织(TransAtlantic Inter-Society Consensus Working Group,TASC)-D型髂动脉闭塞性病变腔内治疗的疗效.方法 回顾性分析自2006年6月至2010年6月,TASC-D型髂动脉病变腔内治疗的26例患者(共31条肢体)的临床资料.单纯髂动脉病变10例,髂动脉合并腹股沟以下病变16例.结果 24例患者(28条肢体)获得成功,技术成功率90.3%(28条/31条),成功的28条肢体临床症状改善率100%(28条/28条),治疗成功者共放置支架44枚,其中8条肢体进行腹股沟以下动脉腔内治疗,3条肢体同时行股-腘人工血管旁路术,8例患者辅助超声消融技术.术后踝-肱指数(ankle-brachial index,ABI)为0.67±0.16,较术前0.37 ±0.15提高,两者差异有统计学意义(t=13.24,P<0.01).随访22例(26条肢体),时间3～44个月,平均(22±11)个月.1年初期通畅率90%(18/20);二期累积通畅率95%(19/20);3年初期通畅率70%(7/10),二期累积通畅率80%(8/10).结论 对于难以耐受外科手术的TASC-D型髂动脉病变可以选用腔内治疗.

Abstract：

Objective To evaluate recanalization for TASC-D type iliac artery lesions.Methods Between June 2006 and June 2010,26 patients with a total of 31 limbs of the TASC-D iliac artery lesions underwent endovascular procedure. Results Technical success rate was 90.3% (28/31).Clinical symptom improvement rate was 100%. Forty-four stents were placed in 28 limbs of the 24 patients.Eleven patients underwent an associated procedure; femoropopliteal endovascular procedures in 8 cases,femoro-popliteal bypass in 3 cases. Eight patients underwent an intravascular ultrasound thrombolysis.Postoperative ankle-brachial index ( ABI) was increased by more than 0. 15 in all patients. Twenty-two patients(26 limbs) were followed-up for 3 -44 mos, the primary patency rate at 12 months was 90% ,and cumulative patency rate was 95%. At 36 months primary patency rate was 70% , and secondary patency rate was 80%. Conclusions Because the technical success rate is high, endovascular techeniques are the choice of therapy in high risk patients with TASC-D type iliac artery lesions.

Endovascular procedure for TASC-D type iliac artery lesions

Objective To evaluate recanalization for TASC-D type iliac artery lesions.Methods Between June 2006 and June 2010,26 patients with a total of 31 limbs of the TASC-D iliac artery lesions underwent endovascular procedure. Results Technical success rate was 90.3% (28/31).Clinical symptom improvement rate was 100%. Forty-four stents were placed in 28 limbs of the 24 patients.Eleven patients underwent an associated procedure; femoropopliteal endovascular procedures in 8 cases,femoro-popliteal bypass in 3 cases. Eight patients underwent an intravascular ultrasound thrombolysis.Postoperative ankle-brachial index ( ABI) was increased by more than 0. 15 in all patients. Twenty-two patients(26 limbs) were followed-up for 3 -44 mos, the primary patency rate at 12 months was 90% ,and cumulative patency rate was 95%. At 36 months primary patency rate was 70% , and secondary patency rate was 80%. Conclusions Because the technical success rate is high, endovascular techeniques are the choice of therapy in high risk patients with TASC-D type iliac artery lesions.