切换至 "中华医学电子期刊资源库"

中华介入放射学电子杂志 ›› 2014, Vol. 02 ›› Issue (02) : 33 -36. doi: 10.3877/cma.j.issn.2095-5782.2014.02.009

所属专题: 文献

血管介入

介入腔内治疗在下肢动脉硬化闭塞症的应用
周意明1, 姜蕾2,(), 翟仁友1, 高堃1, 魏宝杰1, 王剑锋1, 黄强1   
  1. 1. 100020 首都医科大学附属北京朝阳医院介入科
    2. 北京医院放射科
  • 收稿日期:2013-12-06 出版日期:2014-05-01
  • 通信作者: 姜蕾

Application of interventional endovascular treatment for lower extremity arteriosclerosis occlusion

Yiming Zhou1, Lei Jiang2,(), Renyou Zhai1, Kun Gao1, Baojie Wei1, Jianfeng Wang1, Qiang Huang1   

  1. 1. Interventional Department of Interventional Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2013-12-06 Published:2014-05-01
  • Corresponding author: Lei Jiang
  • About author:
    Corresponding author: Jiang Lei, Email:
引用本文:

周意明, 姜蕾, 翟仁友, 高堃, 魏宝杰, 王剑锋, 黄强. 介入腔内治疗在下肢动脉硬化闭塞症的应用[J/OL]. 中华介入放射学电子杂志, 2014, 02(02): 33-36.

Yiming Zhou, Lei Jiang, Renyou Zhai, Kun Gao, Baojie Wei, Jianfeng Wang, Qiang Huang. Application of interventional endovascular treatment for lower extremity arteriosclerosis occlusion[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2014, 02(02): 33-36.

目的

探讨下肢动脉硬化闭塞症(LEASO)的介入腔内治疗。

方法

收集37例LEASO患者,共进行40次手术,处理病变血管56支,其中狭窄病变39处(39/56,69.64%),闭塞病变17处(17/56,30.36%),其中髂动脉病变19处(19/56,33.93%),股动脉病变30处(30/56,53.57%),胫动脉病变7处(7/56,12.50%)。

结果

支架植入6处,球囊成形(PTA)9处,PTA+支架植入38处,手术成功率为94.64%(53/56),术后30天内无死亡病例。手术成功病例术后临床症状明显改善或消失,术前踝肱指数(ABI)为0.35±0.05,术后明显升高(0.73±0.14,P<0.01)。

结论

介入腔内治疗LEASO成功率高,安全可靠,可显著改善临床症状。

Objective

To explore interventional endovascular treatment for lower extremity arteriosclerosis occlusion (LEASO).

Methods

A total of 40 interventional operations were applied in 37 patients with LEASO. There were 56 vascular lesions, including 39 sclerotic lesions (39/56, 69.64%) and 17 occlusive lesions (17/56, 30.36%). There were 19 iliac lesions (19/56, 33.93%), 30 femoral lesions (30/56, 53.57%) and 7 tibial lesions (7/56, 12.50%).

Results

Stents were applied in 6 lesions. Percutaneous transluminal angioplasty (PTA) was applied in 9 lesions. PTA combined with stents were applied in 38 lesions. The success rate of operation was 94.64% (53/56 ). No death occurred within 30 days after treatments. The symptoms of lower limb ischemia were palliated or vanished in operation successful patients. Pre-operation ankle brachial index (ABI) was 0.35±0.05, post-operation ABI increased to 0.73±0.14 (P<0.01).

Conclusions

Interventional endovascular treatment has an high success rate, it is safe and effective for LEASO, and can significantly improve clinical symptoms.

1
孙英信,张依仁,刘象和. 下肢动脉粥样硬化闭塞症治疗的临床研究[J]. 第三军医大学学报, 2002, 24(4):467-469.
2
刘昌伟. 下肢动脉硬化闭塞症的外科治疗进展[J]. 中国临床医生杂志, 2009, 37(3):4-5.
3
周玉斌,吴丹明,徐克. 下肢动脉硬化闭塞症手术治疗进展[J]. 中华老年心脑血管病杂志, 2007, 9(2):141-142.
4
Bosiers M, Hart JP, Deloose K, et al. Endovascular therapy as the primary approach for limb salvage in patients with critical limb ischemia: experience with 443 infrapopliteal procedures. Vascular. 2006,14(2):63-69.
5
Lee LK, Kent KC. Infrainguinal occlusive disease: endovascular intervention is the first line therapy[J]. Adv Surg, 2008,42:193-204.
6
Kudo T, Chandra FA, Ahn SS. The effectiveness of percutaneous transluminal angioplasty for the treatment of critical limb ischemia: a 10-year experience[J]. J Vasc Surg, 2005,41(3):423-435; discussion 435.
7
Suding PN, McMaster W, Hansen E, et al. Increased endovascular interventions decrease the rate of lower limb artery bypass operations without an increase in major amputation rate[J]. Ann Vasc Surg, 2008, 22(2):195-199.
8
刘昌伟. 下肢动脉硬化性闭塞症治疗指南[J]. 中国实用外科杂志. 2008,(11):923-924.
9
Yilmaz S, Sindel T, Yegin A, et al. Subintimal angioplasty of long superficial femoral artery occlusions[J]. J Vasc Interv Radiol, 2003, 14(8):997-1010.
10
Kougias P, Chen A, Cagiannos C, et al. Subintimal placement of covered stent versus subintimal balloon angioplasty in the treatment of long-segment superficial femoral artery occlusion[J]. Am J Surg, 2009, 198(5):645-649.
11
Henry M, Henry I, Klonaris C, et al. Clinical experience with the OptiMed sinus stent in the peripheral arteries[J]. J Endovasc Ther, 2003,10(4):772-779.
12
陈忠. 主髂动脉硬化性闭塞治疗的疑难问题及解决策略[J]. 中国实用外科杂志, 2006,26(10):748-751.
13
Roos JE, Rakshe T, Tran DN, et al. Lower extremity CT angiography (CTA): initial evaluation of a knowledge-based centerline estimation algorithm for femoro-popliteal artery (FPA) occlusions[J]. Acad Radiol, 2009,16(6):646-653.
14
刘历,吴景全,李信友, 等. 64层螺旋CT血管成像在下肢动脉硬化性闭塞症诊断中的价值[J]. 第三军医大学学报, 2008,30(22):2136-2138.
15
Narins CR. Access strategies for peripheral arterial intervention[J]. Cardiol J,2009,16(1):88-97.
16
Bolia A, Brennan J, Bell PR. Recanalisation of femoro-popliteal occlusions: improving success rate by subintimal recanalisation[J]. Clin Radiol, 1989,40(3):325.
17
Ascher E, Hingorani A. Subintimal angioplasty[J]. J Cardiovasc Surg (Torino), 2007,48(1):45-48.
18
Tartari S, Zattoni L, Rizzati R, et al. Subintimal angioplasty as the first-choice revascularization technique for infrainguinal arterial occlusions in patients with critical limb ischemia[J]. Ann Vasc Surg, 2007,21(6):819-828.
19
Met R, Van Lienden KP, Koelemay MJ, et al. Subintimal angioplasty for peripheral arterial occlusive disease: a systematic review[J]. Cardiovasc Intervent Radiol, 2008,31(4):687-697.
20
刘兆玉,畅智慧,卢再鸣, 等. 股腘动脉双入路技术在长段股浅动脉闭塞介入治疗中的应用[J]. 中国临床医学影像杂志, 2009,20 (11): 842-844.
21
Pappy R, Hennebry TA, Abu-Fadel MS. Retrograde access via the popliteal artery to facilitate the re-entry technique for recalcitrant superficial femoral artery chronic total occlusions[J]. Catheter Cardiovasc Interv, 2011,78(4):625-31.
22
Fanelli F, Lucatelli P, Allegritti M, et al. Retrograde popliteal access in the supine patient for recanalization of the superficial femoral artery: initial results[J]. J Endovasc Ther, 2011,18(4):503-509.
[1] 杨城, 李祖儿, 刘青, 赵渊, 徐崇燕, 苏军, 张文云. 新型三维复合骨修复支架的制备工艺及其生物学性能[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(04): 219-229.
[2] 徐逸男. 不同术式治疗梗阻性左半结直肠癌的疗效观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 72-75.
[3] 康婵娟, 张海涛, 翟静洁. 胰管支架置入术治疗急性胆源性胰腺炎的效果及对患者肝功能、炎症因子水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 667-670.
[4] 李佳伟, 庞建智, 闫鹏宇, 卫阳兵, 杨晓峰. 术中输尿管识别技术研究进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 520-524.
[5] 杨文刚, 赖义明, 黄浩, 黄海. 斜跨位上下联通置入Allium覆膜输尿管支架治疗输尿管狭窄的初步经验[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 340-345.
[6] 马振威, 宋润夫, 王兵. ERCP胆道内支架与骑跨十二指肠乳头支架置入治疗不可切除肝门部胆管癌疗效的Meta分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 807-812.
[7] 韩加刚, 王振军. 梗阻性左半结肠癌的治疗策略[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 450-458.
[8] 石阳, 于剑锋, 曹可, 翟志伟, 叶春祥, 王振军, 韩加刚. 可扩张金属支架置入联合新辅助化疗治疗完全梗阻性左半结肠癌围手术期并发症分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 464-471.
[9] 梁轩豪, 李小荣, 李亮, 林昌伟. 肠梗阻支架置入术联合新辅助化疗治疗结直肠癌急性肠梗阻的疗效及其预后的Meta 分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 472-482.
[10] 张迪, 王春霞, 张学东, 李发馨, 庞淅文, 陈一锋, 张维胜, 王涛. 梗阻性左半结直肠癌自膨式金属支架置入后行腹腔镜手术与开腹手术的短期临床疗效比较[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 375-380.
[11] 孙明策, 韩世焕. 海藻酸盐水凝胶支架在颅骨缺损修复中的应用进展[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 310-314.
[12] 钟小军, 杨清峰, 邹忠元, 丘宁宁, 李见英, 邹四珍, 黄小琴, 郭冠华, 牛立志. 支气管镜联合数字减影血管造影在恶性气道狭窄金属支架置入中的应用[J/OL]. 中华介入放射学电子杂志, 2024, 12(04): 317-322.
[13] 何中海, 贾振宇, 刘圣. 血栓负荷评分对支架取栓治疗急性前循环大血管闭塞首过效应的预测价值[J/OL]. 中华介入放射学电子杂志, 2024, 12(04): 338-343.
[14] 神童, 申程, 张艳艳, 颜欣卓, 甘立军. 冠心病合并类风湿关节炎患者PCI术后死亡一例[J/OL]. 中华诊断学电子杂志, 2024, 12(04): 241-244.
[15] 牟磊, 徐东成, 韩鑫, 徐长江, 韩坤锜, 薛叶潇, 牟媛, 秦文玲, 刘相静, 陈哲, 高楠. 五虫通络胶囊防治椎动脉开口支架术后再狭窄发生的效果[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 467-472.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?