摘要
目的:探讨腔内治疗的疗效及2年内的随访结果。方法:回顾性分析我院2006年7月—2011年6月的222例下肢动脉硬化闭塞症患者的资料,共274条患肢。本组病例中男162例,女60例,平均年龄(67.5±11.2)岁。根据不同的病变部位分为:主髂动脉病变92条肢体,股腘动脉101条肢体,膝下动脉31条肢体,多节段病变50条肢体;根据不同的病变程度分为:Rutherford 3级116条肢体,Rutherford 4级87条肢体,Rutherford 5级37条肢体,Rutherford 6级34条肢体。用超声、CTA及DSA等辅助检查方法,进行腔内治疗术后2年内随访。结果:269条肢体技术成功,265条肢体临床成功,单纯球囊扩张86条肢体,球囊成形+支架植入183条肢体。术后30 d内因心衰、重度感染及休克死亡4例,膝上截肢2例。本组病例中完成随访患肢235条,随访9～24月,平均(20.8±4.7)月。2年时血管初次通畅率为71.5%,二次通畅率为75.7%。踝关节以上截肢9例,保肢率96.2%。结论:腔内治疗下肢动脉硬化闭塞症通畅率较好,2年内十分有效。
Objective： To determine the efficacy, safety, and 2-year outcome, including patency and limb salvage, of endovascular revaseularization in patients with lower extremity atherosclerosis obliterans. Methods： From July 2006 to June 2011, 274 limbs in 222 patients with lower extremity atherosclerosis obliterans were treated by endovascular revascularization. There were 162 males and 60 females, with the mean age of 67.5±11.2 years old. Ninty-two limbs in the aorta-iliae group, 101 limbs in the infrainguinal group, 31 limbs in the infra-popliteal group, and 50 limbs in multiple segment group. The most common presenting symptom was severe intermittent elaudication（Rutherford 3, n=l16）, followed by rest pain（Rutherford 4, n= 87）, non-healing ulcer （Rutherford 5, n=37） and gangrene （Rutherford 6, n=34）. Patency was evaluated by using ultrasound scanning, CTA or DSA if necessary, and follow-up status was evaluated with the Kaplan-Meier method. Results： Immediate procedural and clinical success were achieved in 269 and 265 limbs respectively. Eighty-six limbs underwent angioplasty, while the rest 183 limbs underwent angioplasty plus stent placement. There were four perioperative death, and two major amputations within the first 30 days. Mean follow-up was 20.8±4.7 months （range, 9～75 months）. Two hundred and thirty-five limbs had effective follow-up. Primary patenty rate, secondary patenty and limb salvage rate at 2 years were 71.5%, 75.7%, and 96.2%, respectively. Conclusion： Endovascular revascularization is a feasible, safe, and effective procedure for the treat- ment of lower extremity atherosclerosis obliterans.
出处
《中国临床医学影像杂志》
CAS
2013年第4期259-263,共5页
Journal of China Clinic Medical Imaging
