摘要
目的探讨Viabahn覆膜支架植入治疗股腘动脉支架内再狭窄(in-stent restenosis,ISR)的临床效果。方法2018年5月~2020年11月,我科对16例下肢动脉硬化闭塞症股腘动脉支架植入术后发生ISR,造影明确病变部位和性质,经球囊或减容技术行充分管腔准备后,采用Viabahn覆膜支架植入技术重建原病变血管。结果16例股腘动脉ISR血管均重建成功,Viabahn覆膜支架植入技术成功率100%。术前踝肱指数(Ankle-Brachial Index,ABI)0.31±0.12,显著低于术后0.89±0.12(t=-48.257,P=0.000);术前后Rutherford分级差异有统计学意义(Z=-3.568,P=0.000)。围手术期无手术相关的并发症发生。16例随访12个月,3例再发支架内再狭窄,6个月靶血管二期通畅率为100.0%(16/16),12个月二期通畅率为81.2%(13/16),12个月内未发生支架断裂和截肢的病例。结论股腘动脉ISR的处理,尤其是残余狭窄严重或合并支架断裂,使用Viabahn覆膜支架能有效扩张管腔,提高通畅率。
Objective To evaluate the clinical effect of Viabahn covered stent implantation in the treatment of in-stent restenosis of femoropopliteal artery.Methods From May 2018 to November 2020,there were 16 patients diagnosed with lower extremity arteriosclerosis obliterans who developed in-stent restenosis after femoropopliteal artery stent implantation.The location and nature of the lesions were clearly identified by angiography,and adequate lumen preparation was performed by balloon or volume reduction techniques.Intraoperative reconstruction of the original diseased blood vessel was performed with Viabahn covered stent implantation technique.Results The 16 patients with in-stent restenosis of the femoropopliteal artery were successfully reconstructed and treated with Viabahn implantation,with a technical success rate of 100%.The preoperative ankle-brachial index(ABI)was 0.31±0.12,which was significantly lower than the postoperative 0.89±0.12(t=-48.257,P=0.000).There was a significant difference in Rutherford grade before and after surgery(Z=-3.568,P=0.000).No surgery-related complications occurred during the perioperative period,and all the patients were followed up for 12 months.Three patients experienced in-stent restenosis within 12 months of follow-up.The target vessel secondary patency rate at 6 months was 100%(16/16),and the secondary patency rate at 12 months was 81.2%(13/16).There were no cases of stent rupture and amputation within 12 months.Conclusion In the treatment of in-stent restenosis of the femoropopliteal artery,especially if the residual stenosis is severe or combined with stent fracture,the use of the Viabahn covered stent can effectively expand the lumen and improve the patency rate,which is a promising treatment method.
作者
郭坚东
张艳
林印胜
刘玉龙
李王海
李明月
韩键
李承志
Guo Jiandong;Zhang Yan;Lin Yinsheng(Department of Intervention and Vascular Surgery,First Affiliated Hospital of Jinan University,Guangzhou 510632,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2022年第7期565-569,共5页
Chinese Journal of Minimally Invasive Surgery
