PTA及药物洗脱支架在老年人腘动脉以下临界缺血性病变的临床应用

目的研究探讨血管腔内治疗技术在老年人腘动脉以下临界缺血性病变应用的可行性及效果。方法回顾性总结2004年8月至2006年4月间中国人民解放军总医院应用球囊扩张成形术(PTA)治疗腘动脉以下病变15例(18条肢体)的效果,其中合并应用药物洗脱支架治疗4条肢体。病人年龄65~89岁,平均76岁。结果PTA技术成功率89%(16/18),治疗病变部位21处;选择性地对4条肢体有复发的局限性短段狭窄闭塞的5处病变应用了5枚药物洗脱支架置入治疗。术中造影即可见病变血管恢复通畅,术后均有不同程度的症状改善。无围手术期死亡及严重并发症发生。44%(8/18)术后6个月有复发,在多数复发病人中能够成功地再次进行PTA。结论PTA及药物洗脱支架在腘动脉以下病变应用的技术上可行并可重复治疗;近期临床意义主要表现在改善症状、保趾、保足或促进溃疡愈合方面。

PTA and drug eluting stents of infrapopliteal arteries in senile patients with critical chronic limb ischemia

Objective To evaluate the safety and efficacy of percutaneous transluminal angioplasty (PTA) and endovascular drug-eluting stent (DES) implantation for the treatment of the diseases.Methods From August 2004 to April 2006,15 patients (18limbs) were treated with PTA,4 of them were treated with DES for intermittent claudication,rest pain and ischemic ulcer.The age of patients was from 69 to 89 years old,and the mean age was 76 years old.Results The initial successful rate of PTA was 89% (16/18),4 of them were treated with 5 DES for simple,localized restenosis or occlusions.The follow-up period ranged from 2 to 20 months,and the cumulative patency was 56% (10/18).Conclusion The PTA and endovascular DES implantation for the treatment of atherosclerotic occlusive in infrapopliteal arteries is safe and efficient.No serious complications are reported,and further study of the method may improve the results.