跨膝关节腘动脉闭塞治疗发展趋势及面临的主要问题

对于慢性下肢动脉缺血患者,血管腔内治疗具有微创,围手术期并发症少,技术成功率高等特点。与传统开放手术相比,血管腔内治疗具有创伤小,围手术期并发症少的特点。但易发生血管再狭窄,这也是影响其推广的重要原因。腘动脉置入支架可因为关节活动导致支架变形,甚至折断,从而导致支架内再狭窄。近来随着支架的改良及斑块旋切术等新技术,通过血管腔内技术治疗腘动脉病变的成功率得到不断改善,但远期效果还有待进一步论证。

Development Trend and the Main Problem of Across the Knee Popliteal Artery Occlusion Therapy

Endovascular therapy is a minimally invasive treatment for patients suffering from intermittent claudication or critical limb ischemia （CLI） due to peripheral artery disease （PAD）. The main advantages of percutaneous revascularization are a low complication rate and high technical success rate. However, late clinical failure due to restenosis remains the major draw- back limits widespread application of this technique. Stent placed in popliteal region was prone to occlusion due to deformation and fracture. Recently, with the improvement of the second generation nitinol stent, initial problems with stent fractures seem to be resolved. Nevertheless nitinol stenting is still associated with restenosis. Atherectomy with new debulking devices are now available to overcome the limitation of stent placement, but the long term outcomes need to be addressed by further study.