双导丝球囊在药物涂层球囊治疗股腘动脉硬化闭塞症中的效果分析

目的探讨应用双导丝球囊预处理病变，是否会对药物涂层球囊（drug coated balloon，DCB）治疗股腘动脉硬化闭塞症的疗效产生影响。 方法回顾性分析于本中心诊疗的股腘动脉硬化闭塞症患者40例的临床资料，其中20例接受普通球囊（plain-balloon-angioplasty，PBA）结合DCB（对照组）治疗，20例接受双导丝球囊结合DCB（观察组）治疗，根据TASC分级标准将所有患者进行分级，并记录围手术期不良事件的发生，监测患者术前及术后3个月、6个月及1年踝肱指数（ankle brachial index，ABI），1年随访时需对其进行Rutherford分级。 结果2组病例均顺行真腔开通病变，完成手术治疗，2组病例靶血管病变长度及狭窄程度差异无统计学意义(P＞0.05)，预处理后残余狭窄率均低于30%，术中远端栓塞2例，观察组1例；对照组1例，最终截肢。对照组球扩后有1例患者出现限流性夹层，应用补救支架1枚。40例患者均获得随访，2组病例ABI均较术前升高，术后3、6、12个月呈逐渐降低的趋势，2组在组间、时点间、组间·时点间交互作用差异均有统计学意义（P＜0.05）。 结论对于股腘动脉硬化闭塞症，相比PBA结合DCB，双导丝球囊结合DCB可有效降低再干预率，且并未增加并发症发生率，但该结论尚需大样本、长期随访数据支持。

Efficacy analysis of vascutrak balloon combined with drug-coated balloon in the treatment of femoral-popliteal atheroclesrotic occlusive disease

ObjectiveTo explore whether the use of vascutrak balloon to pretreat lesions will affect the efficacy of drug-coated balloon(DCB) in the treatment of femoral-popliteal atheroclesrotic occlusive disease. MethodsThe clinical data of 40 patients with femoral-popliteal atheroclesrotic occlusive disease treated in our center were retrospectively analyzed. Twenty cases underwent plain balloon angioplasty(PBA) combined with DCB(control group), while 20 cases received dual-wire balloon angioplasty and DCB(observation group). All patients were classified according to TASC grading standards, and the occurrence of perioperative adverse events was recorded. The ankle brachial index(ABI) was monitored before and at 3 months, 6 months, and 1 year after operation respectively. Rutherford classification was performed at 1-year follow-up. ResultsIn both groups, the lesions were opened surgically in the true cavity and the surgery was performed. There was no significant difference in the length and stenosis of target vascular lesions between two groups(P＞0.05). The residual stenosis rate after pretreatment was less than 30%. There were 2 cases of distal embolization, one case in the observation group and one in the control group who was amputated ultimately. One patient in the control group had a restrictive dissection after balloon expansion, and received bail-out stenting. All 40 patients were followed up. The ABIs of the two groups were higher than those before operation, but gradually decreased at 3, 6, and 12 months after operation. The difference of interaction between groups, time points and time points between groups were statistically significant in two groups(P＜0.05). ConclusionFor femoral-popliteal atheroclesrotic occlusive disease, vessel preparation with dual-wire balloon angioplasty and subsequent DCB, as compared with PBA combined with DCB, can decrease reintervention rate, and does not increase the incidence of complications, However, this conclusion still needs to be confirmed by large samples and long-term follow-up data.