摘要
目的探讨紫杉醇药物涂层球囊(DCB)治疗股腘动脉支架内再狭窄(ISR)的近期临床疗效。方法 2016年7月至2016年12月采用紫杉醇DCB治疗股腘动脉ISR 18例,其中男15例,女3例,平均年龄(72.7±9.8)岁;FontaineⅡB级9例,Ⅲ级8例,Ⅳ级1例;术前CTA证实ISR 3例,完全闭塞15例。所有患者开通病变后先予普通球囊预扩张,再用DCB后扩张,仍有限流性夹层或残余狭窄>50%则植入补救式支架。术后即刻造影评价血管通畅情况,术后第3日测定患肢ABI评估缺血改善情况。术后3个月随访再狭窄率、临床驱动靶病变血运重建(TLR)率、3个月内严重临床事件。结果 18例患者均成功开通病变血管,技术成功率100%。2例植入补救式支架。15例完成术后3个月随访,10例复查下肢动脉CTA或超声,靶病变再狭窄发生率为10%(1/10);临床驱动TLR率为6.67(1/15)。所有患者未发生操作相关严重临床事件。结论紫杉醇DCB治疗腘股动脉ISR是安全、有效的选择。
Objective To evaluate the short-term effect of drug-coated balloon （DCB） with paclitaxcl in treating in-stent restenosis （ISR） of femoral popliteal artery. Methods A total of 18 patients with femoral popliteal artery ISR, who were admitted to authors＇ hospital during the period from June 2016 to December 2016 to receive paclitaxel DCB treatment, were enrolled in this study. The patients included 15 males and 3 females, with a mean age of （72.7±9.8） years old. According to Fontaine classification, grade Ⅱ B was seen in 9 patients, grade m in 8 patients, and grade 1V in one patient. Preoperative CT angiography showed that ISR could be confirmed in 3 patients and complete occlusion of the stent in 15 patients. After the diseased artery was re-opened, pre-dilatation with common balloon was conducted, which was followed by dilatation with paclitaxel DCB; remedial stent implantation was carried out when the restrictive dissection was observed or if the residual stenosis was beyond 50%. Angiography was performed immediately after the procedure to check the vascular patency. On the third day after the treatment, the ankle-brachial index （ABI） of diseased lower extremity was determined to assess the improvement of ischemia. Three month after the treatment, the patients were followed up to determine the incidence of restenosis, the clinically-driven target lesion revascularization （TLR） rate, and the occurrence of serious clinical events within 3 months. Results Successful re-opening of the diseased artery was achieved in all 18 patients, the technical success rate was 100%. At 3 months after the treatment, the restenosis rate and TLR rate were 10% （1/10） and 6.67% （1/15） respectively. No procedure-related complications occurred in all patients. Conclusion For the treatment of femoral popliteal artery ISR, the use of paclitaxel DCB is safe and effective. （J Intervent Radiol, 2017, 26： 544-547）
出处
《介入放射学杂志》
CSCD
北大核心
2017年第6期544-547,共4页
Journal of Interventional Radiology
关键词
股胭动脉
支架内再狭窄
紫杉醇
药物涂层球囊
femoral popliteal artery
in-stent restenosis
paclitaxel
drug-coated balloon
