Straub Rotarex System血栓栓塞的临床应用血栓旋切器治疗动脉

目的 探讨Straub Rotarex System血栓旋切器治疗动脉血栓栓塞的疗效及应用价值。方法9例下肢动脉栓塞的患者，其中胭动脉栓塞4例，股动脉栓塞3例，髂动脉栓塞1例，髂动脉闭塞合并胭动脉栓塞1例。栓塞原因5例为动脉硬化，4例为心脏栓子脱落；病程1d～5个月；栓塞长度为5～13cm；对1例左髂动脉闭塞及胭动脉栓塞患者先行左髂动脉血管内扩张成形及支架置入术后再对胭动脉血栓行旋切治疗，8例动脉栓塞患者直接采用血管内血栓旋切治疗，对其中2例旋切治疗术后血管狭窄〉50％的患者行球囊扩张治疗。术后给予抗凝、抗感染治疗1周。结果9例患者顺利完成了血栓旋切、球囊扩张及支架置入治疗，血栓被清除、血管狭窄消失、血流恢复正常，未出现并发症。结论 Straub Rotarex血栓旋切器治疗动脉血栓栓塞是一种安全、高效的新方法，具有较高的临床应用价值。     

腔内治疗原发性主动脉血栓10例

目的 探讨原发性主动脉血栓腔内治疗方法,评价其临床疗效。方法 回顾性分析2018年8月至2022年4月收治的10例原发性主动脉血栓患者临床资料。术前CTA检查明确主动脉血栓分型并进行抗凝治疗。对Ⅱ型病变行全身麻醉下支架植入术,Ⅳ型和Ⅲ+Ⅳ型病变行局部麻醉下取栓或支架植入术。采用双股动脉切开或穿刺入路,术中应用Fogarty球囊或Wallstent支架半释放技术预防动脉远端栓塞。周围血管栓塞治疗中仅对下肢动脉、肠系膜上动脉栓塞患者行腔内治疗,其余部位抗凝治疗。取出的血栓行病理学检查。术后继续抗凝治疗。术后1、3、6、12个月随访主动脉CTA及下肢动脉彩色超声,12个月后电话随访。结果 血栓分型Ⅳ型5例,Ⅲ+Ⅳ型2例,Ⅱb型1例,Ⅱa+Ⅱb型2例。取栓4例,直接裸支架治疗2例,直接覆膜支架治疗4例。4例取栓手术应用Fogarty球囊保护,术中未发生血栓异位栓塞;支架植入患者中2例行Wallstent支架保护,其中1例成功抓捕脱落的血栓。周围血管栓塞病变保守治疗4例,腔内手术6例,其中2例髂动脉支架植入,Fogarty球囊取栓3例（2例复发,共5次手术）,大腔导管取栓1例。术后随访1～43个...     

经皮血栓旋切抽吸术加内支架植入术在下肢动脉闭塞性病变中的应用

目的探讨经皮血栓旋切抽吸术加内支架植入术治疗下肢动脉闭塞性病变的疗效。方法1例右股浅动脉中下段闭塞17d,溶栓3d无效,行经皮血栓旋切抽吸术,开通后残留狭窄70％。术后26h血栓形成,立即溶栓后,再植入内支架。结果通过上述方法,患者右股浅动脉、胭动脉及其以远动脉开放。随访6个月后仍正常。结论经皮血栓旋切抽吸术加内支架植入术对下肢动脉闭塞性病变治疗效果确切。     

AngioJet机械性血栓清除装置治疗急性肠系膜上动脉栓塞初步临床效果

【摘要】 目的 探讨AngioJet机械性血栓清除装置治疗急性肠系膜上动脉栓塞（ASMAE）的可行性、安全性和有效性。 方法 回顾性分析2017年4月至2020年1月收治的12例ASMAE患者。其中男6例,女6例,年龄为（74.4±10.5）岁;肠系膜上动脉起始段闭塞1例,中段闭塞7例,起始段＋中段闭塞4例。采用AngioJet装置实施肠系膜上动脉血栓清除,对治疗后还存在血管残余狭窄者予以球囊扩张成形和/或支架植入。术后早期根据症状、体证评估疗效,术后1、3、6 个月进行腹部增强CT检查评估肠系膜上动脉通畅情况。 结果 所有患者均顺利完成抽栓治疗,技术成功率100%。抽吸时间为30～161 s,平均（81.0±39.3） s;术中尿激酶用量（10～30）×104U,平均（15.8±6.7）×104U。8例肠系膜上动脉栓塞部位完全再通,4例行补充性球囊扩张和/或支架治疗后血管恢复通畅,其中2例单纯扩张、1例支架植入、1例球囊扩张结合支架植入。无动脉损伤和肾功能损害等并发症。临床有效11例,无效1例,死亡1例。术后第1、3、6个月门诊随访,患者无腹痛、黑便、腹泻等症状。11例患者CTA检查提示肠系膜上动脉管腔血流通畅,无狭窄/闭塞表现。结论 AngioJet机械性血栓清除装置治疗ASMAE方法安全可行,初步临床疗效满意。     

流变血栓清除术在治疗外周动脉闭塞性疾病中的应用

目的　评价流变血栓清除术治疗外周动脉闭塞性疾病的临床疗效与安全性。方法　对2 0例阻塞时间在 90d内的外周动脉闭塞患者 ,其中闭塞段位于肱动脉 1例 ,髂动脉 2例 ,髂股动脉2例 ,股浅动脉 9例 ,股动脉 1例 ,动脉 2例 ,胫后动脉 2例 ,腓动脉 1例 ,闭塞长度 4～ 2 1cm ,平均(12 1± 4 8)cm ,采用经皮穿刺方法置入 6F或 7F 2种型号Hydrolyser流变溶栓导管并与高压注射器相接 ,将生理盐水以 4ml/s的注射流率和 5 171kPa的压力注入行流变血栓清除术治疗 ,观察血管再通、临床疗效和并发症发生情况。结果　流变血栓清除术后 ,19例 (95 % )重建了前向血流并清除了大部分血栓物质 ,技术成功率 (残留狭窄 <5 0 % )为 85 % (17/ 2 0 ) ;12例附加经皮经腔血管成形术 (PTA)、3例附加内支架治疗 ;18例 (90 % )临床症状有不同程度改善 ,无改善者 2例 ,其中 1例截肢。 2 4h及30、90d的初始血管开放率分别为 95 %、80 %和 70 %。与流变血栓清除术相关的并发症有远端栓塞1例 ,血管破裂 1例。结论　流变血栓清除术能迅速、安全有效地清除急性或亚急性血栓。     

主动脉-髂动脉闭塞介入重建术的中期随访

目的 评价主动脉-髂动脉闭塞介入治疗的中期疗效.方法 回顾性分析30例经介入治疗的腹主动脉.双侧髂动脉狭窄或闭塞患者的临床资料.30例中男24例、女6例,年龄35～75岁,平均(55±10)岁.采用导丝开通、导管溶栓、球囊扩张及支架置入等介入方法 治疗,出院后通过电话、信函、门诊复查等方式随访.结果26例腹主动脉-双侧髂动脉重建成功;3例分别因1条髂动脉开通失败仅腹主动脉.单侧髂动脉重建成功;1例主动脉-髂动脉重建失败.髂动脉破裂1例行WallGraft支架修补.术中发生远端动脉栓塞2例.1例一侧患肢缺血加重接受截肢.27例随访1～112个月,平均(41±9)个月.术后6个月髂动脉闭塞1例未能开通;25个月后双侧髂动脉闭塞1例,经球囊导管扩张治疗后3个月再闭塞,行双侧髂动脉支架置入.23例患肢均无症状再发或加重.结论主动脉-髂动脉介入重建术可有效恢复下肢血供,中期疗效良好.     

综合介入治疗左下肢深静脉血栓合并Cockett综合征临床分析

目的探讨急性左下肢深静脉血栓形成合并Cockett综合征的综合腔内介入治疗方法的应用价值。方法 2010年7月～2011年6月对57例左下肢急性深静脉血栓形成合并Cockett综合征患者采用下腔静脉滤器置入术、左下肢深静脉置管溶栓术及左髂静脉闭塞或狭窄段球囊扩张内支架术治疗,观察患者手术前后左下肢症状及体征,通过造影观察左下肢深静脉通畅情况。结果 57例患者均经下肢深静脉造影检查明确诊断,本组技术成功56例,患者下肢肿胀、疼痛等消失,盆腔侧枝循环消失。1例患者仅行抗凝治疗,下肢肿胀好转。治疗过程中患者未发生滤器、支架移位等情况,未发生血栓复发、肺动脉栓塞、出血并发症等。术后口服抗血小板药物至少3～6个月,随访2～12个月,11例患者左下肢肿胀,7例患者出现下肢静脉曲张,所有患者未发生下肢溃疡,6、12个月后复查造影无支架内阻塞病例。结论综合介入治疗左下肢深静脉血栓形成合并Cockett综合征微创、安全,术后口服抗凝药物可提高下肢深静脉通畅率,临床疗效确切。     

机械性血栓切除和开通治疗慢性血管内血栓

目的　探索机械性血栓切除和开通治疗慢性血管内血栓的可行性 ,初步分析疗效并讨论适应证、禁忌证。方法　本组 2 3例患者血管内血栓均行MRA、血管超声及血管造影证实。其中 12例患有慢性心力衰竭和 (或 )血管性疾病 ,11例为重度糖尿病 ,血栓位于髂动脉 10例 ,股动脉 2例 ,动脉3例 ,髂静脉 7例 ,门静脉 1例。血栓长度为 3～ 8cm ,血栓直径为 5～ 10mm。 7例髂静脉血栓患者行血栓物理性治疗前先行放置下腔静脉滤器。射频消融 (ATD)治疗 9例 (7例静脉 ) ,经皮电动网篮 (PTD) 2例 (门静脉 ) ,流变溶栓 (OASIS) 3例 (动脉 2例 ,静脉 1例 ) ,内支架直接开通 9例 (均为动脉 )。所有患者在血栓治疗过程中采用 5 0万U的尿激酶通过导管内直接进行溶栓。物理性血栓切除后如造影证实血管狭窄者于狭窄部行血管内支架放置。术后治疗包括内科溶栓、肝素抗凝和改善微循环等药物治疗。随访包括血管超声、CT血管重建随访及临床症状随访。结果　 12例 (85 .7% )成功进行了物理性血栓切除。 1例门脉血栓者失败 ,1例股动脉血栓患者同时进行ATD和OASIS治疗。 2 1例 (91.3% )患者症状明显改善和消失 ,包括缺血、肿胀、活动受限。血管超声随访血管通畅率 :10 0 % (3个月 ) ,85 .4 % (6个月 ) ,73.2 % (12个月 ) ;同时 3个月、     

腔内介入治疗Cockett综合征伴左下肢深静脉血栓形成

目的 探讨Cockett综合征伴左下肢深静脉血栓形成(DVT)腔内介入治疗的临床效果.方法 回顾性分析2011年1月至2015年1月收治的256例Cockett综合征伴左下肢DVT患者,采用经导管接触溶栓、球囊扩张闭塞/狭窄段或支架植入术治疗,比较治疗前后患肢周径差、远期通畅率.结果 256例Cockett综合征伴左下肢DVT患者中232例(90.6％)血栓完全溶解.24例(9.4％)部分溶解,治疗前后患肢大腿与小腿周径差分别为(7.12±2.15) cm、(4.57±2.81) cm.206例髂静脉重建患者中单纯球囊扩张46例,球囊扩张联合髂静脉支架植入160例;平均随访15个月(9～24个月),单纯球囊扩张患者失访3例,出现髂静脉闭塞26例(60.5％),血栓后综合征(PTS)21例(48.8％),球囊扩张联合支架植入患者失访11例,支架狭窄/闭塞13例(8.7％),PTS 15例(10.1％),两组闭塞/狭窄、PTS差异有统计学意义(P＜0.001).结论 导管接触溶栓、球囊扩张联合支架植入治疗Cockett综合征,具有确切的临床疗效.     

Cockett综合征伴下肢深静脉血栓的治疗

目的 探讨介入治疗对Cockett综合征伴下肢深静脉血栓形成的临床价值.资料与方法 对2003年12月至2007年7月收治的37例Cockett综合征伴下肢深静脉血栓患者分别采用股静脉、腘静脉或胫后静脉置管溶栓和经皮血管内球囊扩张/支架置入术等血管介入技术进行综合性治疗,观察治疗效果.结果 37例中治愈22例,显效11例,有效4例,总有效率100%,除3例因左髂静脉完全闭塞,置入导丝未能成功外,单纯球囊扩张11例,支架置入23例.本组患者术中、术后无并发症,溶栓过程中未出现出血.临床随访6～12个月,平均9个月,临床无复发,未发现支架移位和变形.结论 综合介入治疗是治疗Cockett综合征伴下肢深静脉血栓的一种安全、有效、微创的治疗手段,值得临床推广.     

一种新的血栓旋切器-Straub Rotarex System及其临床应用介绍

目的 介绍一种新的血栓旋切器——Straub rotarex System及其初步临床应用。方法 应用瑞士应用生产的Straub Rotarex System治疗下肢动脉血检患者4例，发病时间为75d-10个月。2例为动脉硬化引起，1例为栓子脱落，1例为糖尿病引起，动脉闭塞长度为3.8-56cm。结果 血检被清除，血管再通，出血量少，3例次发生远端检塞，均经介入治疗好转，结论 Strub Rotares旋切系统是一种安全有效的血检旋切器。     

Early experience and midterm follow-up results with a new,rotational thrombectomy catheter

Purpose: To assess the efficacy and safety of the Rotarex rotational thrombectomy catheter in treating occlusions of the femoropopliteal arteries. Methods: The Rotarex catheter (Straub Medical, Switzerland) is a rotational thrombectomy device which is supposed to be able to remove fresh and partially organized clot material from an acutely or subacutely occluded vessel. Nineteen limbs of 18 patients (10 women, 8 men; mean age 72.9 ± 7.3 years) with acute or subacute (23 ± 16 days) occlusions of the middle or distal third of the superficial femoral artery or the popliteal artery were treated. The occlusions were 3–20 cm long. Results: Thrombectomy was technically successful in 15 of 19 vessels (79%). The primary procedural success including additional procedures such as angioplasty and/or stent-graft placement in 17 limbs was 94%. The mean ankle-brachial index improved from 0.36 ± 0.26 (before thrombectomy) to 0.81 ± 0.21 (2 days after the procedure) (p = 0.012). Clinical symptoms shifted to at least one Fontaine stage lower in 13 limbs. As complications we observed two perforations (arteries showing heavily calcified plaques), one arteriovenous fistula and three distal embolizations. One perforation, the fistula and one intimal tear after percutaneous transluminal angioplasty were treated with covered stents; the three distal embolizations were treated successfully with aspiration or Rotarex thrombectomy. In the other perforation the intervention was terminated. None of the complications needed surgical treatment. The complication rate was 31.5%. Follow-up studies showed three early (4–11 days) and six late (1–6 months) reocclusions. The cumulative primary patency rate was 68 ± 12% at 3 months, and 39 ± 13% at 6, 12 and 19 months; the secondary patency rate was 68 ± 12% at 3 months and 53 ± 13% at 6, 12 and 20 months. Conclusion: The Rotarex thrombectomy catheter is effective and quick in treating acute and subacute occlusions of the superficial femoral and popliteal arteries. It should not be used in arteries with heavily calcified plaques because of the risk of perforation. Limited long-term patency is mainly due to the complexity of the underlying lesion. Our results suggest that the Rotarex mechanical thrombectomy catheter is effective and might serve as an alternative treatment modality to intra-arterial lysis.     

Massive Pulmonary Embolism: Treatment with the Rotarex Thrombectomy System

This study was designed to evaluate the efficacy and safety of percutaneous mechanical thrombectomy (PMT) for acute massive pulmonary embolism (PE). Fourteen patients (8 men, 6 women) with a mean age of 55.4 (range, 38?C71) years with acute massive PE were initially diagnosed by computed tomography (CT) and confirmed by pulmonary angiography. All patients presented with acute PE symptoms and hemodynamic compromise. Each patient was treated with Straub Rotarex thrombectomy device and five patients received additional thrombolysis. Technique success and clinical improvement were achieved in all patients without major complications. The mean pulmonary artery pressure (PAP) decreased from 37.6?±?6.6 to 29?±?6.4?mmHg (P?<?0.01) after PMT. Partial arterial pressures of O₂ (PaO₂) increased from 61.1?±?9.2 to 88?±?5.1?mmHg (P?<?0.01). The Miller index was 0.67?±?0.11 and 0.37?±?0.13 (P?<?0.01), respectively, before and after PMT (P?<?0.01). Eleven patients had no recurrence of PE on a mean follow-up of 28.3?months, whereas the other three patients were lost to follow-up. The preliminary experience in our series suggests that the Straub Rotarex thrombectomy device, which has been utilized in peripheral arteries, also is useful for the treatment of acute massive PE.     

主-髂-股动脉闭塞性病变介入治疗的技术探讨及疗效观察

目的探讨主-髂-股动脉闭塞性病变介入治疗的技术要点。方法本组34例主-髂-股动脉闭塞的患者中，腹主动脉下段、双侧髂动脉完全闭塞8例，同时肾动脉受累3例；单侧髂动脉闭塞23例，其中病变累及股总动脉4例；单纯单侧股浅动脉长段闭塞3例。分别行闭塞段开通、经导管局部溶栓、血管腔内成形术(PTA)和内支架置人等多种介入方法综合治疗。结果除3例髂动脉闭塞未能开通外，8条腹主动脉，36条髂动脉，4条股总动脉和3条股浅动脉均得以开通，开通率为94％。共置入裸支架46枚，覆膜支架3枚。其中包括腹主动脉支架6枚，髂动脉支架34枚，股总动脉支架2枚、股浅动脉支架4枚和肾动脉支架3枚。在治疗成功的31例中，9例临床症状和体征得到缓解，21例明显改善，1例因长期慢性肾功能衰竭于术后第2天死亡；其中4例合并有并发症。术后平均随访21．5个月(2～53个月)，除2例分别在术后2个月和14个月发生支架内再闭塞行二次介入治疗外，其余患者症状均无加重或复发。结论综合应用多种介入方法治疗主-髂-股动脉闭塞性病变是一项安全有效的治疗手段，可获得满意的临床效果。     

时间分辨随机轨道MR血管成像对周围动脉闭塞性疾病小腿动脉的成像研究

目的 评价3.0 T时间分辨随机轨道(TWIST)MRA提供的小腿动脉血流动力学指标和形态学诊断的价值.方法 40例临床证实或怀疑周围动脉闭塞性疾病(PAOD)的患者接受小腿段TWIST MRA及全下肢对比增强MRA(CE-MRA)检查.由TWIST MRA确定双侧腘动脉开始显示时间,双侧腘动脉开始显影时间差,小腿动脉通过时间和小腿动脉平均达峰时间.分析小腿动脉平均达峰时间与踝肱指数(ABI)的关系.评价小腿各段动脉在TWIST MRA及CE-MRA的图像显示情况,包括血管显示度、静脉重叠情况和动脉狭窄程度.组间比较采用t检验或校正t检验,动脉平均达峰时间与ABI的关系采用Pearson分析.对16例患者,以DSA为金标准,分别评价TWIST MRA、CE-MRA诊断各级动脉狭窄的敏感性和特异性.结果 (1)纳入评价的79侧下肢腘动脉开始显影时间为(30.7±7.6)s,双侧腘动脉开始显影时间差为(2.1±2.5)s,小腿动脉通过时间为(35.6±16.9)s,小腿动脉平均达峰时间为(52.6±17.6)s.(2)24例接受ABI检查的患者共计得到48个ABI指数(均值为0.62±0.23),与小腿动脉平均达峰时间呈正相关(r＝0.627,P＜0.01).(3)851段参与评价的血管中,TWIST MRA显影动脉节段849段,显示度评分为(2.83±0.48)分;CE-MRA显影动脉节段845段,显示度评分为(2.78±0.43)分(P＞0.05).(4)以DSA共显示的194段动脉节段为金标准,TWIST MRA显示正常及轻度狭窄的敏感性为96.7%(118/122)、特异性为100.0% (72/72),显示明显狭窄的敏感性为94.1%(32/34)、特异性为96.2% (154/160),显示闭塞的敏感性为94.7%(36/38)、特异性为98.7% (154/156);CE-MRA显示正常及轻度狭窄的敏感性为95.9%(117/122)、特异性为100% (72/72),显示明显狭窄的敏感性为91.2%(31/34)、特异性为95.6% (153/160),显示闭塞的敏感性为94.7%(36/38)、特异性为98.1%(153/156).结论 TWIST MRA操作简便,无静脉污染,一次检查不仅能准确显示小腿动脉病变,而且能提供反映疾病程度的功能学信息.

Abstract：

Objective To explore the value of time-resolved angiography with interleaved stochastic trajectories (TWIST)in providing hemodynamic indices and morphological imaging of calf arteries in patients with peripheral arterial occlusive disease(PAOD) with 3.0 T MR scanner. Methods Forty patients with confirmed or suspected PAOD underwent TWIST MRA for the calf arteries and conventional contrast-enhanced MRA(CE-MRA) for the whole lower peripheral arteries. TWIST MRA data were used to determine the bolus arriving time of the popliteal artery, the time difference of the bolus arrival in the popliteal artery between the two legs, calf artery transit time, and the mean peak enhancement time of calf arteries. The mean value of peak enhancement time of calf arteries was correlated with ankle-brachial index(ABI). The calf arteries were divided into 13 segments. The visible score of arterial segment was recorded, and the degree of arterial stenosis was graded too. In 16 patients, DSA was used as the gold standard to evaluate the sensitivity and specificity of TWIST MRA and CE-MRA. Results The bolus arriving time of the popliteal artery was (0.7±7.6) s the time difference of the bolus arrival in the popliteal artery between the two legs was (2.1±2.5) s, the calf artery transit time was (35.6±16.9) s, the mean value of peak enhancement time of calf arteries was (52.6±17.6) s. ABI was acquired from 24 patients and 48 legs, which correlated well with the mean value of peak enhancement time in calf arteries (r＝0.627,P＜0.01). The mean visible score was (2.83±0.48) of TWIST MRA images and (2.78±0.43) of CE-MRA images. There was no significant difference between them (P＞0.05). On CE-MRA, there were 38 legs with varying degrees of early venous enhancement; in contrast, there was no venous contamination on TWIST MRA. The sensitivity and specificity of TWIST MRA were 96.7% (118/122) and 100.0% (72/72) in showing normal artery and mild stenosis, 94.1% (32/34) and 96.2% (154/160) in showing severe stenosis, and 94.7% (36/38) and 98.7% (154/156) in showing occlusion. The sensitivity and specificity of CE-MRA were 95.9% (117/122) and 100.0% (72/72) in showing normal artery and mild stenosis, 91.2% (31/34) and 95.6% (153/160) in showing severe stenosis, and 94.7% (36/38) and 98.1% (153/156) in showing occlusion. Conclusion TWIST MRA is a preferable choice for calf arterial occlusive disease, which provided nice morphological images and useful hemodynamic indices with simple operation.     

四肢动脉狭窄伴血栓形成的急诊介入治疗

目的 评价四肢动脉狭窄伴血栓形成急诊介入治疗的临床意义。方法 26例四肢动脉狭窄伴血栓形成的患者实施了急诊OASIS导管流变溶栓、ATD浸软溶栓或尿激酶溶栓术，对狭窄段采取经皮球囊扩张(PTA)和支架成形术，其中锁骨下动脉3例，髂动脉5例，股动脉7例，胭动脉4例，胫前胫后动脉及足部动脉4例，人造血管2例，支架术后再狭窄1例。结果 PTA或支架置入术后狭窄段的血管腔复通率100％，溶栓术后血栓完全消失，患肢远端血运明显改善或恢复，临床症状消失。DSA或B超随访1～20个月，动脉均保持通畅。溶栓后消化道出血1例，无截肢病例。结论 采用急诊机械性和药物性溶栓术结合PTA和支架治疗四肢动脉狭窄伴血栓形成，可有效地解除动脉闭塞，避免截肢。     

Treatment of complex arteriosclerotic lesions with nitinol stents in the superficial femoral and popliteal arteries: a midterm follow-up.

PURPOSE: To evaluate the effectiveness of nitinol stents in patients with short, complex lesions in the superficial femoral and popliteal arteries and to assess midterm results. MATERIALS AND METHODS: Self-expandable nitinol stents were implanted in 54 extremities in 44 patients to treat complex stenoses (n = 32) and occlusions (n = 22) in the superficial femoral and popliteal arteries. Follow-up was performed for 5-51 months to evaluate early thrombosis and midterm patency rates. Midterm patency rates were compared between the following: stenoses and occlusions, proximal and distal locations, good and poor runoff, and diabetic patients and nondiabetic patients. All patients underwent clinical investigation and color Doppler sonography after 1 month and 6 months and at 6-month intervals thereafter. If restenosis or stent thrombosis was suspected, intraarterial digital subtraction angiography of the superficial and popliteal arteries was performed. RESULTS: Percutaneous stent implantation was successful in all patients. The mean duration of follow-up was 27 months (range, 5-51 months). No thrombotic occlusion occurred within the first 4 weeks after stent implantation. The primary 3-year patency rate was 76%, and the secondary patency rate was 87%. Three-year primary patency rates were 65% for diabetic patients and 82% for nondiabetic patients. CONCLUSION: In patients with short, complex stenoses and occlusions, implantation of nitinol stents may have a positive impact on midterm results.     

Radionuclide angiography of the popliteal arteries in occlusive vascular disease

Before undertaking a femoro-popliteal bypass graft it is important to know whether the popliteal artery is patent to receive the distal end of the graft. Patency was assessed in 48 studies of 46 patients with peripheral vascular disease by radio-nuclide angiography. The procedure consists of imaging the popliteal arteries using a gamma camera after a bolus injection of 99mTc-sodium pertechnetate. The radio-nuclide angiograms were compared with the operative X-ray popliteal angiograms. Reliable information was obtained from the radio-nuclide images regarding the patency of the popliteal artery provided a femoral pulse was present. Quantitative data generated from the activity time curves were of no value in assessment of the patency of the popliteal arteries.     

A comparison of nuclear magnetic resonance and intravenous xeroangiography with conventional arteriography in popliteal artery imaging

Twenty-nine patients with peripheral vascular disease had the popliteal artery segment assessed by xeroangiography and nuclear magnetic resonance (NMR) scanning. The result of each test was compared with conventional contrast arteriography. Nuclear magnetic resonance and xeroangiography correctly predicted popliteal artery patency in 97% and 100% of limbs, respectively, and occlusion was correctly predicted in 44% and 63% of limbs. The ability of xeroangiography to define the state of the popliteal artery accurately makes this a useful method in high-risk patients. The potential for NMR imaging appears very promising but more work is required to define its future clinical application.