药物灌注球囊以及股动脉逆行内膜剥脱术治疗下肢动脉粥样硬化闭塞症腔内治疗术后再狭窄

目的:探讨下肢动脉粥样硬化症(arteriosclerosis obliterans,ASO)支架植入术后再狭窄治疗策略的可行性及安全性。方法:回顾分析2016年1月1日—2016年7月1日5例行药物球囊灌注后支架植入术及2012年6月1日—2016年7月1日15例股动脉逆行内膜剥脱术的下肢ASO支架植入术后再狭窄患者的临床资料,分析手术效果及随访期内并发症的发生情况,评价上述治疗手段的可行性、安全性。结果:20例患者行药物球囊灌注后支架植入术或股动脉逆行内膜剥脱术后,远端肢体得到充分的血流灌注,患肢皮温较前明显改善,足背动脉可触及搏动;患者自觉患肢温暖,疼痛症状明显减轻,术后随访均无再狭窄发生。结论:药物球囊灌注后支架植入术及股动脉逆行内膜剥脱术治疗下肢ASO支架植入术后再狭窄安全有效,能降低支架植入术后再狭窄的风险。

Abstract:Objective: Retrospective analysis of clinical technique and specialtySof treatments for vascular restenosis after stent implantation inSatherosclerosis lesions. This article aims to have a discussion about the effectiveness and safety of the two therapy strategies in our single unit.

Objective: Retrospective analysis of clinical technique and specialty of treatments for vascular restenosis after stent implantation in atherosclerosis lesions. This article aims to have a discussion about the effectiveness and safety of the two therapy strategies in our single unit.Methods: The clinical data of 45 cases who had received drug-perfused balloon and 15 cases who had received femoral artery retrograde endarterectomy after presenting reocclusion or restenosis atherosclerosis lesions from June 2012 to June 2016 in our Vascular Surgery were reviewed retrospectively. We collected the data of restenosis or reocclusion cases following initial endovascular treatment and restenosis or reocclusion cases after our treatment in atherosclerosis in lower limb and evaluated the effectiveness, availability and safety of the two treatment strategies which are mentioned above by doing follow-up in these 60 patients.Results: 60 patients, altogether having 84 diseased limbs, had acquired an adequate blood perfusion in their distal limbs and got warmer on their feet after undergoing drug-perfused balloon and stent implantation or femoral artery retrograde endarterectomy. In addition, they can have good palpitation in dorsal artery of feet and have better feelings on account of relieving pain. In their follow-up, 2 restenosis cases have been found in the drug-perfused balloon group while no restenosisor reocclusion cases have occurred in retrograde endarterectomy group.Conclusion: The application of the stent angioplasty after using drug-perfused balloon and femoral artery retrograde endarterectomy on vascular restenosis after stent implantation in atherosclerosis lesions proved to be effective and safe, greatly reducing the restenosis or reocclusion frequency in patients who were treated in our unit.