Application of interventional endovascular treatment for lower extremity arteriosclerosis occlusion

doi:10.3877/cma.j.issn.2095-5782.2014.02.009

Abstract

Abstract:

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

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.

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References 22

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.

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