摘要
目的探讨动脉粥样硬化性股-腘动脉闭塞性疾病介入治疗的方法和临床疗效。方法本组43例58处病变,狭窄性36处,闭塞性22处,采用球囊成形、支架成形、腔内旋切和内膜下血管成形等多种介入手段干预、治疗。结果58处病变:单纯球囊成形8例,辅助支架成形的17例(15例自膨式支架,4例弹簧式支架),均成功;单纯腔内旋切6例,辅助支架成形的11例(15例自膨式支架,1例弹簧式支架),手术失败1例;单纯内膜下血管成形3例,辅助支架成形的8例(13例自膨式支架,2例弹簧式支架),手术失败4例。31例临床症状明显改善,18例症状和体征得到缓解,5例疗效欠佳。4例患者因术后缺血再灌注损伤行切开解压后好转,2例因小腿骨筋膜室综合征行膝关节以下离断术。术后平均随访10.5个月(2～33月),2例术后6月症状复发未予进一步治疗,1例术后1年再次介入治疗,余患者疗效稳定。结论股-腘动脉闭塞性疾病的介入治疗方法多种多样,针对不同程度的病变采用不同的介入治疗手段,临床治疗效果安全、可靠。
Objective To explore the technical methods and clinical efficacy of interventional treatments on atheroslerosis obliterans of femoropopliteal arteries.Methods Forty-three patients with thirty-six stenosis changes and twenty-two occlusive changes received interventional treatments including percutaneous transluminal angioplasty（PTA）,implantation of stent（IS）,subintimal angioplasty（SIA） and mechanical thrombectomy（MTE）.Results 8 changes with simple PTA and 17 with ally of IS（15 self-expandable stents and 4 recoiling stents）,6 changes with simple MTE and 12 changes with ally of IS（15 self-expandable stents and 2 recoiling stents）,3 changes with simple SIA and 8 changes with ally of IS（13 self-expandable stents and 2 recioling stents）.In 53 successfully treated changes,there were 30 changes with relief of symptoms and signs,18 cases with obvious improvement,and 5 changes without any improvement.But 4 cases received operation to relieve the tension of lower extremities from ischemia-reperfusion injury and 2 cases received amputation.All the patients were followed-up for 2-33 months（mean 10.5 months）.Among them,two cases with restenosis did not receive any interventional recanalization after 6 months and one case with restenosis after simple PTA successfully received IS.Conclusion Various interventional treatments have respective strong points to treat different atheroslerosis obliterans of arteries.Comprehensive application of them can be a safe and effective method for atheroslerosis obliterans of femoropopliteal arteries.
出处
《当代医学》
2010年第5期9-11,共3页
Contemporary Medicine
关键词
股-腘动脉
闭塞性病变
介入治疗
femoropopliteal arteries
atheroslerosis obliterans
interventional treatment
