重症下肢缺血的血管腔内治疗

目的评价血管腔内治疗下肢动脉硬化闭塞症重症下肢缺血的临床效果。方法2005年4月-2006年5月采用血管腔内治疗重症下肢缺血24例共29条肢体，主要临床症状均为静息痛，其中合并溃疡或肢端坏疽12例（50％）。本组29条肢体均接受血管腔内治疗，其中有4条肢体行单纯球囊扩张，4条肢体术中同时行股胭动脉人工血管旁路术联合膝下胭胫动脉血管腔内球囊扩张成形术，21条肢体行支架植入。结果股胭动脉球囊扩张和支架植入技术成功率为100％，膝下动脉球囊扩张成功率为88％，术后患者临床症状明显好转，静息痛消失，溃疡愈合。围手术期膝下截肢1例，截肢率为3．4％。结论血管腔内治疗下肢动脉硬化闭塞症重症下肢缺血是一种安全有效的治疗方法。

Endovascular treatment of critical leg ischemia of arteriosclerosis obliterans

Objective To evaluate the outcomes of percutaneous transluminal angioplasty (PTA) and stenting in the treatment of critical lower extremity ischemia of arteriosclerosis obliterans. Methods From April 2005 to May 2006, PTA and stenting was performed on 29 limbs of 24 patients with critical lower limb ischemia. Among all these patients, their main clinical symptom was rest pain, while ulceration and gangrene were also found in 12 patients. Four limbs underwent PTA, 4 limbs underwent prosthetic femoral-popliteal bypass with infrapopliteal balloon dilatation simultaneously, and the remaining 21 limbs were performed by PTA and stent placement. Results The success rate of endovascular procedure was 100% for femoral-popliteal artery, and 88% for infrapopliteal artery. Rest pain disappeared and the ulcers were healed after the operations. Only 1 patient received amputation during the operation. Conclusion Endovascular therapy is an effective and safe procedure for the treatment of critical lower limb ischemia.