老年周围动脉疾病综合介入治疗的临床观察

目的　探讨综合介入治疗老年周围动脉疾病的临床疗效及安全性。方法　采用经皮穿刺周围动脉血管球囊扩张术 (PTA)、支架置入、持续动脉内溶栓加PTA、血管内膜剥离术加支架置入术等综合介入方法治疗老年周围动脉阻塞性病变 6 2例次 ,其中上肢锁骨下动脉阻塞性病变 2 1例次 ,下肢动脉病变 4 1例次。单纯PTA 6例次 ,球囊预扩张加支架置入术 5 2例次 ,溶栓加PTA 3例次 ,股动脉内膜剥离术加髂动脉支架置入术 1例。结果　手术成功率95 % ,手术并发症 1.4 % (支架脱落 1例 )。术后即刻血管造影影像学和临床表现明显改善。随访 3个月～ 2年 ,无复发性肢体缺血症状生存 6 7% ,间歇性跛行较术前减轻并维持 13% ,临床再狭窄率 2 0 %。结论　老年周围动脉阻塞性病变综合介入治疗近、远期疗效满意 ,手术安全可靠 ,肢体复发性缺血症状发生率相对较低 ,是目前治疗老年周围动脉疾病的有效方法之一

Clinical evaluation of combined interventional treatment for aged patients with obstructive peripheral arterial disease

Objective To evaluate clinical effectiveness and safety of percutaneous transluminal revascularization for aged patients with obstructive peripheral arterial disease.Method Sixty-two aged patients with obstructive peripheral arterial disease were treated with percutaneous transluminal intervention followed by persistent intra-arterial thrombolysis combined with balloon dilatation,balloon alone or selective stent placement.Of these patients,21 had subclavian arterial disease and 41 had iliac or femoral artrial.disease.Results Primary successful rate of interventional procedure was 95% and major complications were 1.6%(one case had dropping of stent).Sixty-seven percent of patients in stent placement group lived without recurrent limb ischemia symptoms and 13% of patients(who had incomplete recanalization)had intermittent claudication improved persistently during follow-up.Clinical recurrent ischemic symptoms occurred in 20% of the patients with successful recanalization.Conclusion Percutaneous transluminal intervention for aged patients with obstructive peripheral arterial disease was effective and safe.The immediate and long-term results were satisfactory.