Viabahn腔内人工血管治疗髂股动脉长段闭塞性病变的疗效评价

目的: 探讨Viabahn腔内人工血管治疗髂股动脉长段闭塞性病变的临床经验和预后,评价其在外周动脉闭塞性病变治疗方面的疗效。方法: 回顾性分析经腔内介入治疗的78例(89条肢体)髂股动脉长段闭塞性病变患者的临床资料。根据患者意愿分为裸支架组(42例,48条肢体)和Viabahn腔内人工血管组(36例,41条肢体),比较2组患者的一般资料、围手术期情况、远期通畅率和保肢率等,随访时间为3~12个月,平均随访11.08个月。结果: 术后2组患者缺血症状明显改善,踝肱指数(ABI)较术前均明显升高(P<0.05);术后随访3、6、9个月2组患者的一期和二期通畅率比较差异无统计学意义(P>0.05),Viabahn腔内人工血管组患者12个月后一期通畅率和二期通畅率均明显高于裸支架组(P<0.05);2组患者的1年保肢率均为100%;Viabahn腔内人工血管组患者术中动脉血栓形成概率明显低于裸支架组(P<0.05)。结论: 应用Viabahn腔内人工血管治疗髂股动脉长段(≥10cm)闭塞性病变是安全、有效的,且其12个月的远期通畅率和术中动脉血栓形成概率明显优于金属裸支架。

Evaluation on curative effect of Viabahn endovascular treatment in transluminal vascular occlusive disease of long segment of iliac-femoral artery

Objective: To discuss the experiences and therapeutic effects of Viabahn endovascular treatment in transluminal vascular occlusive disease of long segment of iliac-femoral artery,and to evaluate its curative effect in occlusive disease of peripheral artery. Methods: The clinical data of total 78 patients (89 lower limb) with transluminal vascular occlusive disease of long segment of iliac-femoral artery were collected and the patients were divided into bare stent group (42 cases,48 lower limb) and Viabahn group (36 cases,41 lower limb).The general information,peri-operative and long-term patency rate,and rate of limb salvage of patients in two groups were collected.The follow-up time was 3-12 months and the average follow-up time was 11.08 months. Results: Compared with before operation,the ischemic symptoms of the patients in two groups after operation were improved and the ankle brachia index(ABI) was increased(P<0.05).3,6,and 9 months after post-operative follow-up,the primary and secondary patency rates of the patients in two groups showed no significant difference (P>0.05).12 months after post-operative follow-up,the primary and secondary patency rates of the patients in Viabahn group were higher than those in bare stent group (P<0.05).The 1-year limb salvage rates of patients in two groups were 100%.The patients in bare stent group had more risk to suffer stent thrombosis than those in Viabahn group (P<0.05). Conclusion: Using Viabahn for treatment of transluminal vascular occlusive disease of long segment of iliac-femoral artery (≥10 cm) is safe and effective,and the 12-month long-term patency rate and the risk to suffer stent thrombosis are superior to bare stent.