切换至 "中华医学电子期刊资源库"
高级检索
中华介入放射学电子杂志

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:
全文 ( ) 下载PDF ( ) 导出引用
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]. 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]. 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。

关键词: 动脉硬化闭塞症, 介入腔内治疗, 支架, 经皮血管腔内成形术
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.

Key words: Arteriosclerosis occlusion, Interventional endovascular treatment, Stents, Percutaneous transluminal angioplasty
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]. 中华口腔医学研究杂志(电子版), 2024, 18(04): 219-229.
[2] 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]. 中华普外科手术学杂志(电子版), 2024, 18(06): 667-670.
[3] 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]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 520-524.
[4] 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]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 340-345.
[5] 方道成, 陈立新, 胡媛媛. 输尿管支架结壳的相关研究进展[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 402-405.
[6] 张继新, 谢爽, 王雪莲, 武祖印, 梁延洋, 张春旭. 经鼻插入肠梗阻导管联合NOSES微创治疗梗阻性结直肠癌的研究[J]. 中华结直肠疾病电子杂志, 2024, 13(03): 189-196.
[7] 杨金朔, 吴桥伟, 王春雷, 史怀璋. 脑血管内支架成形术后再狭窄的研究进展[J]. 中华神经创伤外科电子杂志, 2024, 10(03): 174-179.
[8] 赵峰, 邓默. 纤维蛋白原水平、踝肱指数与外周血管支架治疗下肢动脉硬化闭塞症后再狭窄的关系[J]. 中华临床医师杂志(电子版), 2024, 18(02): 144-151.
[9] 崔斯童, 马骏, 刘亮, 夏加庚, 刘振. 双微导管与支架辅助技术治疗颅内未破裂宽颈分叶状动脉瘤的疗效对比分析[J]. 中华介入放射学电子杂志, 2024, 12(03): 200-205.
[10] 葛学慧, 邢超然, 商晓芬. 体外预开窗联合分支支架技术治疗椎动脉异位起源于主动脉弓的Stanford B型夹层患者一例[J]. 中华介入放射学电子杂志, 2024, 12(03): 281-283.
[11] Kun Yung Kim, 曹家玮, Ho Young Song, Jin Young Kim, 袁航, 胡鸿涛, Jin Yoon Chang. 胃十二指肠支架置入术[J]. 中华介入放射学电子杂志, 2024, 12(02): 97-105.
[12] 徐啸阳, 张帅, 仲斌演, 沈健, 朱晓黎. 血管腔内介入治疗肾动脉瘤的临床疗效分析[J]. 中华介入放射学电子杂志, 2024, 12(02): 137-143.
[13] 陈丽, 陈敏江, 任建敏, 谢艳茹, 涂建飞, 纪建松. 125I放射性粒子条联合胆道支架与单纯胆道支架植入治疗恶性胆道梗阻的术后院内感染发生率及临床疗效的对照研究[J]. 中华介入放射学电子杂志, 2024, 12(02): 144-149.
[14] 周碧芳, 莫伟, 李琴, 李玉莲, 刘爱兰. "5W1H"夹管清单在经皮肝穿刺胆道引流+胆道支架置入术后护理中的应用[J]. 中华介入放射学电子杂志, 2024, 12(02): 180-184.
[15] 郭方明, 赵明俐, 颜凡辉, 刘萌萌, 王阳, 赵英杰, 刘远航, 张艳芬, 詹景冬. 光学相干断层成像在急性心肌梗死冠状动脉分层斑块病变中的应用[J]. 中华诊断学电子杂志, 2024, 12(02): 73-79.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号