下肢动脉长段闭塞的腔内介入治疗

目的探讨下肢动脉长段闭塞腔内介入治疗的技术要点及临床疗效。资料与方法使用腔内介入治疗方法治疗61例共75段长段动脉闭塞性病变。病变长度为10.7～40.5 cm,平均(24.7±7.8)cm。其中13例共13段闭塞动脉采用经皮经腔血管成形术(percutaneous transluminal angioplasty,PTA),48例共62段闭塞动脉采用内膜下血管成形术(subintimal angioplasty,SIA)。结果两种方法结合共有55例69段闭塞动脉再通成功,其中47例临床症状有不同程度改善,8例无明显改善。共发生并发症9例,其中2例因并发症较严重放弃介入手术,余7例经处理后均得以妥善治疗,未影响临床疗效。术后1年随访一期通畅率为75.5%。结论腔内介入治疗安全性高、可行性强,近中期疗效显著,长期疗效需进一步观察。其可部分取代传统外科手术,可作为治疗下肢动脉长段闭塞的首选方法。

Intracavitary Interventional Therapy for Long Occlusion of Artery of Lower Extremity

Objective To assess the technique and clinical outcome of intracavitary interventional therapy for long occlusion of artery of lower extremity.Materials and Methods Sixty one patients with 75 long arterial occlusions underwent intracavitary interventional therapy.The mean lesion length was(24.7±7.8) cm(range,10.7-40.5 cm).Percutaneous transluminal angioplasty(PTA) was performed in 13 patients with 13 arterial occlusions.Subintimal angioplasty(SIA) was performed in 48 patients with 62 arterial occlusions.Results In all,there were 55 patients with 69 arterial occlusions had achieved technical success.47 patients showed varying degrees of improvement in clinical symptom.8 patients did not have obvious improvement.There were 9 patients had developed complication altogether.2 patients cancelled intervention treatment because of severe complication.7 patients had been cured and the curative effect did not affected.The primary patency rate at 1 year was 75.5%.Conclusion The security of intracavitary interventional therapy is high,the feasibility was strong,the short term and the medium term curative effect is significant,the long term curative effect still need to observe.It can be a alternative oftraditional surgery partly,and become the therapy of the first choice for long arterial occlusion of lower extremity.