膝下血管成形术治疗重症肢体缺血的临床疗效

目的评价膝下经皮腔内血管成形术(PTA)治疗重症肢体缺血(CLI)的临床疗效。方法回顾性分析48例(50条患肢)接受膝下PTA治疗的下肢CLI患者,统计PTA的技术成功率、围术期并发症、PTA术后的缺血症状缓解情况、治疗血管的通畅情况和大截肢情况。结果共针对64条膝下动脉施行PTA,技术成功率为85.94%(55/64);围术期并发症发生率为12.50%(6/48)。平均随访(16.25±2.65)个月;PTA术后1、3、6、12、24、36个月的1期血管通畅率分别为92.0%、85.7%、79.0%、75.8%、59.8%、29.9%;保肢率分别为92.0%、92.0%、89.7%、86.4%、82.1%、72.9%。50条患肢中,1、3、6个月时的缺血症状缓解率分别为42.00%(21/50)、70.21%(33/47)和86.36%(38/44)。结论膝下PTA治疗CLI技术可行,安全性高,能有效缓解CLI的静息痛症状、促进肢体溃疡的愈合,避免大截肢的发生。

Clinical outcomes of infrapopliteal angioplasty for critical limb ischemia

Objective To observe clinical outcomes of infrapopliteal percutaneous transluminal angioplasty (PTA) for critical limb ischemia (CLI). Methods A total of 48 patients (50 limbs) who underwent infrapopliteal PTA for CLI were retrospectively studied. Technical success of PTA, perioperative complications, remission of ischemic symptoms after PTA, vessel patency, and major amputation were statistically analyzed. Results A total of 64 infrapopliteal vessels underwent PTA, with 55 (55/64, 85.94%) of them achieving technical success. Perioperative complications occurred in 6 patients (6/48, 12.50%). The mean follow-up was (16.25±2.65)months. The primary patency of the treated vessel at 1-month, 3-month, 6-month, 12-month, 24-month, 36-month were 92.0%, 85.7%, 79.0%, 75.8%, 59.8%, 29.9%, respectively; and the limb salvage rate at the corresponding time were 92.0%, 92.0%, 89.7%, 86.4%, 82.1%, 72.9%, respectively. The remission rate of ischemic symptoms at 1-month, 3-month, and 6-month were 42.00% (21/50), 70.21% (33/47), 86.36% (38/44), respectively. Conclusion Infrapopliteal PTA for CLI is both feasible and safe, which facilitates rest pain remission, limb ulcer healing, and avoidance of major amputation.