介入联合手术治疗多节段性下肢动脉硬化闭塞症43例临床分析

目的探讨多节段性下肢动脉硬化闭塞症的治疗经验。方法采用介入（球囊扩张和／或支架置入）联合手术（内膜剥脱、取栓术、旁路术）治疗多节段性下肢动脉硬化性闭塞症43例（50条肢体）。结果所有病例均进行了介入及手术治疗。41例患者临床症状减轻，踝肱指数（ABI）术前平均为0．199，术后踝肱指数为（O．54±0．15），随访3-48个月，围手术期病死率0％，2例术后出现血栓，经取栓后症状无缓解，最终截肢治疗，截肢率4．6％。结论多节段性下肢动脉硬化闭塞症的复杂性决定了治疗方法的多样性，且此种方法是一种安全有效的治疗方法。

Clinical evaluation of interventional therapy combined with surgery in treating the lower extremity multilevel atherosclerotic occlusive disease in 43 cases

Objective To explore the experience in the treatment of lower extremity multilevel atherosclerotic occlusive disease. Methods Interventional therapy（ either balloon catheter technique or stent implantation） combined with surgery operation （ intima denudation,thrombus removal or bypass surgery） was applied to treat the lower extremity multilevel atherosclerotic occlusive disease in 43 cases（ 50 limbs）. Results All the cases had the interventional treatment and the surgery. Clinical symplom released in 41 cases with the change of ankle brachial index （ABI） from a preoperative median of 0. 199 to the postoperative level as 0.54 ± 0.15, patients were followed up for 3 -48 months, the perioperative mortality rate was 0% , thrombus happened in 2 cases postoperatively, and the symptom did not release after removal of the thrombus, amputation was applied eventually, with an amputation rate of 4.6%. Conclusions The complexity of lower extremity multilevel atherosclerotic occlusive disease determines the variety of treatment, interventional treatment combined with surgery operation has been proved to be effective.