泛大西洋协作组织共识C和D型股腘动脉病变患者腔内治疗的疗效分析

目的 评价泛大西洋协作组织共识(TASC)C型和D型股腘动脉病变患者腔内治疗的近期临床疗效.方法 回顾性分析2007年1月至2009年4月上海仁济医院TASC C型、D型股腘动脉病变患者,95例(98条患肢)施行经皮球囊血管腔内成形术和支架植入术,应用踝/肱指数(ABI)、Fontaine分期、保肢率和通畅率综合评估治疗效果.结果 腔内治疗技术成功率94.9%,围手术期死亡率4.2%,截肢率5.1%;患肢足背和胫后动脉ABI分别由治疗前的0.42±0.17和0.45±0.18提高至治疗后的0.78±0.19和0.78±0.20,差异有统计学意义;重症下技缺血(CLI)的患肢数由治疗前的73.5%减少至治疗后的14.3%,差异有统计学意义.81例84条患肢获得随访,平均随访(13±7)个月,随访保肢率96.4%,随访期足背动脉和胫后动脉ABI分别为0.58±0.22和0.60±0.21,与术前和术后相比,差异均有统计学意义;随访期重症下肢缺血的患肢数占16.4%,与治疗前相比差异有统计学意义,与治疗后相比差异无统计学意义.结论 腔内治疗TASC C型、D型股腘动脉硬化病变的近期临床疗效确切.

The efficacy analysis of endovascular intervention therapy for transatlantic inter society consensus type C and type D femoropopliteal arteriosclerosis lesion

Objective To evaluate the efficacy of the endovascular inter-vention for transatlantic inter society consensus (TASC) type C and type D femoropopliteal artery disease. Methods We conducted a retrospective analysis on 95 cases (98 lower limbs) with TASC type C and type D femoropopliteal artery arteriosclerosis lesion treated by percutaneous transluminal angioplasty and/or primary stent implantation from January 2007 to April 2009. We used ankle brachial index (ABI), Fontaine stages, limb salvage percentage and primary patency to evaluate the efficacy of the endovascular intervention therapy. Results The technical success rate of the 98 limbs was 94.9%, the perioperation mortality was 4. 2% and the total amputation rate was 5. 1%. 81 cases(84 limbs) were followed-up for a mean time of ( 13 ± 7) months,whose average ABI in dorsalis pedis artery and posterior tibial artery were 0. 58 ±0.22 and 0. 60 ±0. 21 and increased 0. 14 ±0. 25 and 0.13 ±0.22 respectively than the ABI before intervention therapy. The statistical analysis showed a significant difference in ABI. The limbs of critical limb ischemia(CLI) were of 16. 4% in the follow-up period and of 73.5% before the intervention therapy. The statistical results showed a significant difference in the percentage of CLI. Conclusion Percutaneous endovascular intervention is an effective and minimally invasive method, and has a curative clinical efficacy to treat TASC type C and type D femoropopliteal artery disease.