药物涂层球囊PTA治疗下肢动脉硬化闭塞症

目的 观察药物涂层球囊经皮腔内血管成形术（PTA）治疗下肢动脉硬化闭塞症（LEAOD）的临床效果。方法 将43例LEAOD患者（43条患肢）随机分为观察组（21例）和对照组（22例）。对观察组给予药物涂层球囊PTA治疗，对照组行普通球囊PTA。记录2组患者术前及术后7天Fontaine分期，分别于术前及术后1、3、6个月统计靶动脉段股浅动脉血管内径、再狭窄率及踝肱指数（ABI），术后6个月时靶动脉段股浅动脉血管狭窄情况。结果 术后7天2组Fontaine分期均较术前降低（P均<0.05）。观察组术后1、3、6个月时靶动脉段股浅动脉内径均大于对照组（P均<0.05），再狭窄率均低于对照组（P均<0.05）；术后3、6个月观察组ABI均大于对照组（P均<0.05）。术后6个月时，观察组14例靶动脉段股浅动脉血管狭窄率<30%、4例30%~50%、3例>50%（无100%者），对照组2例狭窄率<30%、10例狭窄率30%~50%、10例>50%（2例100%），组间比较差异有统计学意义（P<0.01）。结论 药物涂层球囊PTA治疗LEAOD安全、有效，能够降低再狭窄率，且近期疗效优于普通球囊。

Drug-coated balloon PTA in treatment of lower extremity atherosclerotic occlusive disease

Objective To observe effect of percutaneous transluminal angioplasty (PTA) with drug coated balloon for treatment of lower extremity atherosclerotic occlusive disease (LEAOD). Methods Totally 43 LEAOD patients (43 lower limbs) were randomly divided into study group (n=21) and control group (n=22). Patients in study group were treated with drug-coated balloon PTA, and those in control group with general balloon. Fontaine stages before and 7 days after PTA were counted in both groups. The internal diameter, restenosis rate and ankle-brachial index (ABI) of the target artery segment of superficial femoral artery were calculated before PTA and 1, 3, 6 months after PTA, while stenosis rate of the target artery segment of superficial femoral artery was counted at 6 months after PTA. Results Fontaine stage 7 days after PTA were lower in both groups than that before PTA (both P<0.05). One month, 3 and 6 months after PTA, the internal diameter of the target artery segment of superficial femoral artery in study group were larger than that in control group (all P<0.05), while the restenosis rate were lower than that in control group (all P<0.05). Three and 6 months after PTA, ABI of study group were larger than that of control group (both P<0.05). Six month after PTA, the stenosis rate of target artery segment superficial femoral artery in study group were <30% in 14 cases, 30%-50% in 4 cases, >50% in 3 cases (no 100%) while in control group were <30% in 2 cases, 30%-50% in 10 cases, >50% in 10 cases (100% in 2 cases) (P<0.01). Conclusion PTA with drug coated balloon is safe and effective in treatment of LEAOD, which can reduce the rate of restenosis, and the short-term effect is better than that PTA with ordinary balloon.