摘要
目的探讨准分子激光消蚀术(ELA)联合药物涂层球囊(DCB)治疗股腘动脉硬化闭塞症的疗效及其影响因素。方法回顾性分析2019年7月至2022年3月应用ELA联合DCB治疗股腘动脉硬化闭塞症82例患者的临床资料,包括技术成功率、踝肱指数(ABI)、一期通畅率、免于靶病变血运重建(TLR)率等指标,应用Cox回归分析影响一期通畅率和免于TLR率下降的危险因素。结果82例患者均完成了ELA+DCB治疗,技术成功率为91.5%,术后ABI(0.73±0.13)较术前(0.39±0.11)明显提高(t=35.26,P<0.001)。术后24个月的累积一期通畅率和免于TLR率分别为64.1%和76.8%。病变长度>15 cm(HR=2.57,P=0.047)、病变重度钙化(HR=3.26,P=0.021)与一期通畅率的下降相关,患糖尿病(HR=5.24,P=0.010)、术后单一流出道(HR=4.18,P=0.008)与免于TLR率的下降相关。结论ELA联合DCB治疗股腘动脉硬化闭塞症的安全性高,中期疗效良好。病变长度>15 cm和重度钙化是一期通畅率的独立危险因素,糖尿病和术后单一流出道是免于TLR率的独立危险因素。
Objective To investigate the efficacy of excimer laser atherectomy(ELA)combined with drug-coated balloon(DCB)in the treatment of femoropopliteal arteriosclerosis obliterans(ASO)and its influencing factors.Methods The clinical data of patients with femoropopliteal ASO treated by ELA combined with DCB from July 2019 to March 2022 were retrospectively analyzed,including technical success rate,ankle-brachial index(ABI),primary patency rate and freedom from target lesion revascularization(TLR)rate.Cox regression was applied to analyze the risk factors affecting the decline in the rate of primary patency and freedom from TLR.Results All 82 patients were treated with ELA+DCB.The technical success was 91.5%.The post-operative ABI(0.73±0.13)was significantly higher than preoperative ABI(0.39±0.11)(t=35.26,P<0.001).The 24-month cumulative primary patency and TLR-free rates were 64.1%and 76.8%,respectively.Lesion length>15 cm(HR=2.57,P=0.047)and severe calcification(HR=3.26,P=0.021)were associated with loss of primary patency.Having diabetes(HR=5.24,P=0.010)and a single postoperative outflow tract(HR=4.18,P=0.008)were associated with a decrease in TLR-free rates.Conclusions ELA combined with DCB for femoropopliteal ASO is safe and has good intermediate efficacy.Lesion length>15 cm and severe calcification were independent risk factors for primary patency rate,and diabetes and a single postoperative outflow tract were independent risk factors for TLR-free rate.
作者
李攀峰
李晓健
王国权
牛浩
翟水亭
Li Panfeng;Li Xiaojian;Wang Guoquan;Niu Hao;Zhai Shuiting(Department of Vascular Surgery,Fuwai Central China Cardiovascular Hospital,Heart Center of Henan Provincial People′s Hospital,Zhengzhou 450018,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2024年第3期313-317,共5页
Chinese Journal of Radiology
关键词
动脉硬化
闭塞性
股腘动脉
激光
药物涂层球囊
血管成形术
Arteriosclerosis obliterans
Femoropopliteal artery
Laser
Drug-coated balloon
Angioplasty
