股动脉长段病变腔内治疗325例体会

目的探讨腔内治疗股动脉长段闭塞的技术问题。方法 2005年3月～2011年2月采用腔内介入治疗股动脉长段闭塞(闭塞长度均≥10.0cm)患者325例(381条肢体);将其治疗前后踝肱指数(ABI)进行比较,并对治疗后临床疗效及动脉通畅率进行统计分析。结果本组技术成功297例,技术成功率91.4%,15例(4.6%)单纯球扩,282例同时置入支架,术前、术后ABI比较,差异有统计学意义(0.31±0.10vs0.72±0.15,P<0.01)。出院时症状明显缓解者276例。随访206例,随访时间30天至50个月,症状复发55例,复发率26.7%,6例膝上截肢,5例膝下截肢,15例足趾截趾,保肢率88.9%;1、3年累积通畅率分别为62.3%、37.2%。结论腔内治疗股动脉长段闭塞微创、安全,近期疗效确切,注意介入技巧可以提高腔内治疗的成功率。

Endovascular therapy of long occlusive femoral artery

Objective To explore the technical problem of endovascular therapy of long occlusive lesions of the femoral artery.Methods From March 2005 to February 2011,3205 cases(381 limbs,) with long occlusive lesions(the length of occlusive lesions was more than 10.0cm) of the femoral artery were treated by endovascular therapy.Results 297 cases were successfully treated,and technical success rate was 91.4%.15 cases(4.6%) were treated by percutaneous translumial angioplasty(PTA) and 282 cases were treated by PTA conbined with stenting.In successful cases,the ankle-branchial index(ABI) improved from preoperative 0.31± 0.10 to postoperative 0.72 ± 0.15.There were statistical differences in pre-and postoperation(P<0.01).The symptoms were obviously relieved in 276 cases at discharge.206 cases were followed up.The follow-up time was from 30 days to 50 months.Symptoms were recurrent in 55 cases,with recurrence rate of 26.7%.And amputation above knee was performed in 6 cases,amputation below knee in 5 cases,and toe apodizers in 15 cases.The limb salvage rate was 88.9%.The cumulative patent rate in one year and three years were 62.3% and 37.2%,respectively.Conclusions Endovascular therapy of long occlusive lesions of the femoral artery is safe and effective.Appropriate applying operate skills could improve successful rate of endovascular therapy.