双向内膜下血管成形术治疗股浅动脉长段硬化性闭塞疾病16例分析

目的探讨经双向内膜下血管成形术(subintimal arterial flossing with antegrade retrograde intervention,SAFARI)治疗股浅动脉长段硬化性闭塞疾病的临床效果和应用价值。方法选择2011年5月—2013年8月收治的经内膜下血管成形术治疗失败的股浅动脉长段硬化性闭塞疾病16例,经SAFARI开通,采用经皮穿刺腔内血管成形术(PTA)联合内支架(stent)置入。结果全组治疗技术成功率为100%,无严重并发症发生;术后平均随访10(3~18)个月,一期通畅率为93.75%(15/16),二期通畅率为100%。踝肱指数由术前的0.25±0.15增加至术后的0.89±0.19(P0.05)。结论 SAFARI是治疗股浅动脉长段硬化性闭塞所致慢性严重肢体缺血的安全有效的方法。

Subintimal Arterial Flossing with Antegrade-Retrograde Intervention for Subintimal Recanalization in Treatment of Superficial Femoral Artery Long Segment Occlusion in 16 Patients

Objective To investigate the clinical effect and value of subintimal arterial flossing with antegrade-retro- grade intervention （SAFARI） in treatment of superficial femoral artery occlusion. Methods A total of 16 patients with super- ficial femoral artery occlusive disease after conventional subintimal angioplasty failure during May 2011 and August 2013 un- dertook recanalization by SAFARI and percutaneous transluminal angioplasty （PTA） combined with endovascular stent implan- tation. Results The total achievement ratio was 100% without severe complications; with postoperative average follow up for 10 months （3-18 months） , first phase of patency rate was 93.75% （15/16） , and the second phase of patency rate was 100%. The ankle brachial index （ABI） was preoperative 0.25 ± 0.15 and postoperative 0.89 ± 0.19 respectively, and post- operative ABI was significantly higher than that before operation （P 〈 0.05）. Conclusion SAFARI is safe and effective in treatment of chronic critical limb ischemia induced by superficial femoral artery long segment occlusion.