摘要
目的探讨AngioJet机械血栓抽吸结合药物洗脱球囊治疗股腘动脉长段闭塞病变的安全性和有效性。方法选取2018年6月—2019年6月河北医科大学第二医院血管外科收治的股腘动脉长段闭塞病变患者12例临床资料。术前接受踝肱指数(ABI)检查,进行卢瑟福(Rutherford)分级,术中接受AngioJet机械血栓抽吸结合药物洗脱球囊治疗,依据血管造影评估手术即刻效应,并记录围手术期并发症发生情况。术后1周复查ABI。术后1年随访下肢动脉超声、Rutherford分级及ABI等。并记录随访过程中再干预率及病死率。结果共入组12例患者、16处病变,Rutherford分级3级7处,4级8处,5级1处,TASC分级C型10处,D型6处。手术成功率为100%,其中2例病变逆行开通。术中造影1处病变出现非限流性夹层;1例患者发生心绞痛,口服药物后缓解;1处病变发生远端栓塞,围手术期无死亡。1例患者术后3 d出现急性血栓形成,接受二次治疗。术后1周复查ABI为(0.84±0.06),明显高于术前的(0.40±0.07)(t=17.800,P<0.05)。11例患者15处病变获得术后1年随访,术后1年Rutherford分级(0.67±0.87)较术前(3.75±0.62)明显改善(t=10.720,P<0.05),ABI(0.68±0.08)较术前明显提升(t=10.090,P<0.05)。一次手术通畅率为86.67%(13/15),二次手术通畅率为100%(1/1),再干预率为0。随访期间1例患者因冠心病死亡。结论对于股腘动脉长段闭塞病变,AngioJet机械血栓抽吸结合药物洗脱球囊治疗在增加安全性的同时,降低病变再干预率,可作为临床上一种理想选择方案。
Objective To investigate the safety and efficacy of Angiojet mechanical thrombus aspiration combined with drug-eluting balloon in the treatment of long segment femoral popliteal artery occlusion.Methods The clinical data of 12 patients with long segment femoral popliteal artery occlusion treated in the Department of Vascular Surgery of the Second Hospital of Hebei Medical University from June 2018 to June 2019 were selected.The ankle brachial index(ABI)was examined before operation,Rutherford grade was performed,and AngioJet mechanical thrombus aspiration combined with drug-eluting balloon was performed during operation.The immediate effect of operation was evaluated according to angiography,and the occurrence of perioperative complications was recorded.ABI was rechecked 1 week after operation.One year after operation,lower extremity arterial ultrasound,Rutherford grade and ABI were followed up.The re intervention rate and mortality during follow-up were recorded.Results A total of 12 patients and 16 lesions were enrolled.Rutherford grade 3 in 7 cases,grade 4 in 8 cases,grade 5 in 1 case,TASC grade C in 10 cases and grade D in 6 cases.The success rate of operation was 100%,of which 2 cases were retrograde opened.During intraoperative angiography,1 lesion had non flow limiting dissection,1 patient had angina pectoris,which was relieved after oral medication,1 lesion had distal embolism,and there was no death during the perioperative period.One patient developed acute thrombosis 3 days after operation and received secondary treatment.The ABI 1 week after operation was(0.84±0.06),which was significantly higher than that before operation(0.40±0.07)(t=17.800,P<0.05).11 patients were followed up for 1 year after operation.The Rutherford grade(0.67±0.87)was significantly improved compared with that before operation(3.75±0.62)(t=10.720,P<0.05),and the abi(0.68±0.08)was significantly improved compared with that before operation(t=10.090,P<0.05).The primary patency rate was 86.67%(13/15),the secondary patency rate was
作者
袁涛
陶华洁
石电威
张楠
王志波
Yuan Tao;Tao Huajie;Shi Dianwei;Zhang Nan;Wang Zhibo(The Second Hospital of Hebei Medical University,Hebei Province,Shijiazhuang 050000,China;不详)
出处
《疑难病杂志》
CAS
2021年第12期1247-1251,共5页
Chinese Journal of Difficult and Complicated Cases
基金
河北省重点研发计划项目(182777148)。
关键词
股腘动脉闭塞
机械血栓抽吸
药物洗脱球囊
疗效
安全性
Femoropopliteal artery occlusion
Mechanical thrombus aspiration
Drug eluting balloon
Effectiveness
Safety
