支架成形术治疗髂动脉慢性闭塞症的中长期疗效分析

目的:评价支架成形术治疗髂动脉慢性闭塞症的中长期疗效。方法 :回顾性分析我科自2004年1月至2009年12月经支架成形术治疗的髂动脉慢性闭塞病人的技术成功率、支架通畅率及介入并发症。结果:髂动脉慢性闭塞症病人167例(194条患肢)纳入研究,男103例(126条患肢),女64例(68条患肢);平均年龄(71.3±12.4)岁。TASC B型47例(54条患肢),TASC C型88例(102条患肢),TASC D型32例(38条患肢)。TASC B型、C型、D型技术成功率分别为98.1%(53/54)、97.1%(99/102)、94.7%(36/38),各组比较无统计学差异;髂动脉支架成形术后1年一期通畅率、一期辅助通畅率和二期通畅率分别为94.6%、98.8%和98.8%,2年分别为90.0%、94.5%和96.2%,5年分别为78.8%、89.4%和93.5%,TASC各型之间无统计学差异。肱动脉穿刺部位血肿多于股动脉(P=0.047)。结论:支架成形术治疗髂动脉慢性闭塞安全、有效,技术成功率、支架通畅率和并发症发生率与TASCⅡ分型无相关性。

Mid-term and long-term outcomes of stent angioplasty for iliac artery chronic occlusions

Objective To assess the clinical and patency results of stent angioplasty for the treatment of iliac artery chronic occlusions. Methods A retrospective analysis of patients with iliac artery chronic occlusions treated with stent angioplasty was conducted at our department from Jan 2004 to Dec 2009. Technical success, patency, and complications were recorded. Results There were 167 patients 103 men with 126 limbs and 64 women with 68 limbs; mean age,（71.3＋ 12.4） year] with iliae artery chronic occlusions. According to the Trans Atlantic Inter-Society Consensus for the management of peripheral arterial disease （TASC 11 ） classification, 47 patients （54 limbs） were type B, 88 patients （102 limbs） were type C, and 32 patients （38 limbs） were type D. Technical success in type B,C and D was 98.1%（53/54）,97.1% （99/102）,94.7%（36/38）, respectively. The primary patency, primary assisted patency, and secondary patency rates of the iliac artery was 94.6%,98.8% and 98.8% at 1 year, and 90.0%,94.5% and 96.2% at 2 year,and 78.8%,89.4% and 93.5% at 5 year, respectively. There was no statistical difference of technical successes and patency rates among TASC l subgroups. The prevalence of hematoma at the puncture site was higher in the brachial artery than in the femoral artery（P= 0.047）. Conclusions Stent angioplasty is an effective, safe and feasible method for iliac artery chronic occlusions. There was no relation of TASC II subgroups with technical successes, stent patency rates and complications.