慢性主-髂动脉闭塞内膜下再通治疗的可行性及初步应用.pdfVIP

介入盟盟主盘iÏ( 2佣9 年 3 月第 18 卷第 3 期 J Inlervenl Radiol 2侃9. Vo1.J 8. N0.3 …-220叫叫 ·临床研究 Clinical research. 慢性主翩儒动脉闭塞内膜下再通治疗的可行性及初步应用 学京钩，刘涛，徐力扬，张强，路军良 [摘要] 目的 探讨经动脉内膜下途径治疗主·锵动脉闭塞的可行性与治疗方法。方法 对 1 例慢 性主儒动脉闭黎患者经右胧动脉穿刺，使用超滑导丝自腹主动脉闭寨端穿入内膜下眩，分别向两侧骨带动 脉行内膜下属通。有侧导丝顺利意人锵外动脉真腔，左侧使用了双向内膜下再通技术。2~己导丝经双侧股 动脉穿刺点11 出体外。绞肉侧股动脉用对吻技术行球囊扩张和支架最放(主动脉下端文架 l 枚，双侧储 动脉支架 5 枚)。结果 .:ì:幡骨雷动脉闭葱经内膜下途径成功再通。治疗后才2帽曾在动脉支架内胶形态良好，血 流通畅。双下肢缺血症状究全消失，躁臂指数(ABI)由 0.32 上升至0.96 10 个月随访米见再狭窄表现。结 0 论 经动脉内膜下途役治疗吏骸动脉闭寒安全、可行，适用于慢性动脉硬化闭署E病变。 [关键词] 主唰惊动脉:闭塞:内膜下得通;介入治疗 中囱分类号:民543.5; 民816 文献标志码:B 文章编号:1∞8-794X(2ω9)孙子0220-04 Subln仙naI racanaliza创on for the tr阳伽lent 01 chronlc aorto.lliac arteηocclusion: Its fi崎sibility and pre胁时nary results LI Jing仰， LIU r.ω• XU Li-yang , ZHANG Qiang. LU Jun-liang. Dep耐ment 01 Radωlogy ， Beijing Militω丁y District Genera1 Hospit a1, Beijing 1ω7ω， Chi础 [Abstract] Objective To explore the feasibility and proper technique of subintimal racanalization in treating chronic aorto-ilíac artery occlusion. Methods Subintimal racan哗lization via ríght brachial artery acce崎 W捕 performed in a 57-years-old man wíth chronic total occlusion of aort• iliac artery. Subíntimal pathways were created with two hydrophilic 伊idwires (Terom时， which were inserted into the subintimal space from the occluded end of the abdominal aorta and got Înto the right and le仇 extemal iliac 町teries separately. Subintimal arterial flOssing with antegrade-retrograde interventiOn was employed in left sideω OvercOme the difficulty in reentering the true lumen. The exchange guidwires were conducted Out Of the femoral artery puncture sites On bOth sides in sequence , in this way the bilateral femOral pathways were established. Ao忱。制