王中华,陈学东,田磊,王世华,姜福亭,王育红.髂动脉硬化闭塞性病变的介入治疗技术及体会[J].中国介入影像与治疗学,2010,7(5):507-510
髂动脉硬化闭塞性病变的介入治疗技术及体会
Interventional techniques and experience for total occlusion of iliac artery
投稿时间:2010-03-02  修订日期:2010-03-24
DOI:
中文关键词:  髂动脉  内膜下血管成形术  支架
英文关键词:Iliac artery  Subintimal angioplasty  Stents
基金项目:
作者单位E-mail
王中华 海军总医院普通外科,北京 100048 zhonghua.w@163.com 
陈学东 海军总医院普通外科,北京 100048  
田磊 海军总医院普通外科,北京 100048  
王世华 海军总医院普通外科,北京 100048  
姜福亭 海军总医院普通外科,北京 100048  
王育红 海军总医院普通外科,北京 100048  
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中文摘要:
       目的 探讨应用内膜下血管成形术(SIA)联合经皮血管腔内成形术(PTA)介入治疗髂动脉硬化闭塞性病变的技术方法和疗效。方法 对15例伴有严重缺血症状的髂动脉硬化闭塞性病变患者,采用顺行途径穿刺,经左肱动脉穿刺3例,经对侧股动脉穿刺12例。通过SIA对闭塞段动脉进行再通,应用球囊扩张成形并植入支架(裸支架18枚,覆膜支架4枚)。结果 内膜下血管成形术技术成功率100%,支架植入后髂动脉闭塞段管腔形态良好,血流通畅,无严重并发症出现,临床症状消失或明显改善。患肢踝肱指数由术前的0.41±0.12增至术后7天的0.81±0.13 (t=8.76,P<0.0001)。近中期随访2例发生再狭窄,经PTA解除,术后12个月支架一期通畅率为85.71%(12/14)。结论 SIA联合支架植入术治疗髂动脉硬化闭塞性病变安全、有效,近、中期疗效良好。
英文摘要:
      Objective To explore the method and effectiveness of subintimal angioplasty (SIA) combined with percutaneous transluminal angioplasty (PTA) for total occlusion of iliac artery. Methods Fifteen patients of iliac artery total occlusion with chronic critical limb ischemia were enrolled, and antegrade access was applied in all patients (left brachial artery in 3 patients, opposite femoral artery in 12 patients). After SIA for the occluded artery segment, balloon angioplasty of the subintimal space and stents were released (18 naked stents, 4 PTFE-covered stents). Results The technical success rate of subintimal recanalization was 100%. Angiogram showed good blood flow and smooth inner shape of iliac artery. No serious complications occured. The clinical symptoms disappeared or improved significantly. Ankle-brachial index increased from 0.41±0.12 to 0.81±0.13 (t=8.76, P<0.0001). Two patients of restenosis were treated with PTA during midterm follow-up. The primary patency rate was 85.71% (12/14) 12 months after treatment. Conclusion SIA combined with stent implantation are safe and effective to treat iliac artery total occlusion with midterm follow-up.
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