老年患者TASC C、D级髂股动脉闭塞的腔内治疗

目的探讨对泛大西洋协作组织(TASC)C、D级髂股动脉闭塞老年患者行腔内治疗的疗效。方法 104例老年TASC C、D级髂股动脉闭塞患者接受微创腔内介入手术,其中TASC C型73例、TASC D型31例,闭塞长度4.25~17.61cm,平均(13.46±1.24)cm。对腔内介入治疗的临床疗效、并发症、术后随访等情况进行分析。结果 94例成功开通闭塞动脉,技术成功率90.38%(94/104),其中单纯球囊扩张12例、联合支架植入92例。围手术期发生并发症8例,并发症发生率为7.69%(8/104),包括急性动脉血栓2例、穿刺处假性动脉瘤形成1例、心功能衰竭4例、对比剂肾病1例。术后7天踝肱指数由术前的0.32±0.12增至0.81±0.11(P0.01)。术后6个月、12个月各随访78例和53例患者,通畅率分别为88.46%(69/78)、81.13%(43/53)。结论对老年TASC C、D级髂股动脉闭塞患者,微创腔内介入治疗手术成功率高,并发症少,可取得满意的临床疗效。

Endovascular treatment of iliac femoral artery occlusive disease with TASC C, D lesions in elderly patients

Objective To investigate the effect of endovascular treatment in iliac femoral artery occlusive disease of Trans-Atlantic Inter-Society Consensus (TASC) C, D lesions in elderly patients. Methods Totally 104 elderly TASC C, D patients with iliac femoral artery occlusion were treated, including TASC C (n=73), TASC D (n=31). Occlusive length range were 4.25-17.61 cm, with an average of (13.46±1.24)cm. The curative effect, complications and following up after surgery were analyzed. Results Ninty-four patients were treated successfully, and the technical success rate was 90.38% (94/104); 12 patients underwent balloon dilation, 92 patients underwent balloon dilation combined stent. There were 8 cases (8/104, 7.69%) with periprocedural complications, included arterial thrombosis (n=2), pseudoaneurysm (n=1), heart failure (n=4), and radiographic contrast nephropathy (n=1). Doppler ankle-brachial index increased from 0.32±0.12 to 0.81±0.11 (P<0.01) at 1 week after treatment. The patency rates were 88.46% (69/78) and 81.13% (43/53) at 6 and 12 months followed-up respectively. Conclusion Minimally invasive endovascular treatment has high technical success rate, low complication rate, and satisfactory clinical curative effect for iliac femoral artery occlusive disease of TASC C, D lesions in elderly patients.