超声消融配合球囊扩张技术治疗糖尿病下肢动脉闭塞

目的 观察超声消融配合球囊扩张技术治疗糖尿病下肢小动脉闭塞的手术成功率和动脉长期通畅率.方法 对158例糖尿病合并下肢动脉闭寨患者进行下肢动脉CT造影,确定动脉闭塞的部位和范围,采用经皮股动脉穿刺法,首先插入超声消融导管进行动脉内超声消融,然后对仍有狭窄的动脉进行球囊扩张.结果 158例患者149例手术获得成功,9例失败,有效率94%.术后皮温平均增加3℃,间歇性跛行距离延长1 000 m.45例足趾坏死38例愈合,35例静息痛31例缓解.在132例长期随访者中33例发生动脉再闭塞,动脉长期通畅率为75%.结论 超声消融配合球囊扩张技术可以有效治疗糖尿病下肢动脉闭塞,且长期再通率较高.

Ultrasound ablation and balloon angioplasty in treating peripheral arterial occlusion in diabetes mellitus

Objective To evaluate the efficacy of ultrasound ablation and balloon angioplasty in treating peripheral arterial occlusion in diabetes mellims. Methods One hundred and fifty-eight patients with peripheral arterial occlusion were treated with the ultrasound ablation. Through percutaneous approach or surgical approach, the ultrasound ablation catheter was inserted into occluded arterial segments. Results The ultrasound ablation was successful in 149 of 158 patients (94%). After treatment, the average skin temperature rised for 3℃ and the distance of intermittent claudicafion was increased for 1 000 m. The gangrene was mitigated in 38 of 45 patients. The pain during rest was ameliorated in 31 of 35 patients. Long-term efficacy was 75%. Conclusion Ultrasound ablation is effective and is a new approach for treating peripheral arterial occlusion in diabetes mellitus.