长段股浅动脉闭塞腔内治疗__培训课件.ppt

Recross 18 2/80 V18 Recross 2/80 Batam 2.5/80 Everflex 6/200 Frontrunner 辅助 右下肢跛行200米，ABI：0.3 ABI:1.0 Outback导管辅助的SIA Silverhawk 处理支架长段闭塞 SFA的腔内治疗现状 冷冻球囊： Karthik 等认为冷冻球囊对再狭窄病例的通畅率没有显著改善。 Karthik S, Tuite DJ, Nicholson AA, et al.Cryoplasty for arterial restenosis. Eur J Vasc Endovasc Surg. 2007;33:40–43. 切割球囊：Mauri等认为切割球囊比较普通球囊而言并没有显著降低再狭窄的疗效。 Mauri L, Bonan R, Weiner BH, et al. Cutting balloon angioplasty for the prevention of restenosis: results of the Cutting Balloon Global Randomized Trial. Am J Cardiol.2002;90:1079–1083. 内膜旋切：TALON研究显示：内膜旋切配合药物治疗可能会降低再狭窄的发生率。 Ramaiah V, Gammon R, Kiesz S, et al.Midterm outcomes from the TALON Registry: treating peripherals with SilverHawk: outcomes collection.J Endovasc Ther. 2006;13:592–602. 激光消融：Scheinert等报道：激光消融的SFA的一年通常率是33.6%，所以在处理再狭窄上无优势。 Scheinert D, Laird JR, Schroder M, et al.Excimer laser-assisted recanalization of long,chronic superficial femoral artery occlusions.J Endovasc Ther. 2001;8:156–166. 药物涂层支架： SIROCCO II研究显示其半年的再狭窄率为0%，对比裸支架7.7%。可能会是降低再狭窄的一个好选择。 Duda SH, Bosiers M, Lammer J, et al. Sirolimus-eluting versus bare nitinol stent for obstructive superficial femoral artery disease: the SIROCCO II trial. J Vasc Interv Radiol.2005;16:331–338. “腔内治疗操作成功率超过82%,而肢体挽救成功率甚至高达98%,临床效果可媲美甚至超过外科搭桥手术。” 我们努力要把腔内治疗做得更好！ 1st Hosp of D.M.U 长段股浅动脉闭塞腔内治疗 王峰 纪东华 大连医科大学附属第一医院介入科 前 言 TASC II -2007 Type C lesions - Multiple stenoses or occlusions totaling 15 cm with or without heavy calcification - Recurrent stenoses or occlusions that need treatment after two endovascular interventions Type D lesions - Chronic total occlusions of CFA or SFA(20 cm, involving the popliteal artery) - Chronic total occlusion of popliteal artery and proximal trifurcation vessels “Bypass better than Endovascular” Charing Cross 33 New TASC guidelines are set to recommend an endovascular first strategy even for TASC D lesions. Johannes Lammer, Vienna, Austria, told CX 33 delegates