股深动脉优势供血治疗tascd型动脉硬化下肢缺血的疗效分析.docVIP

·临床研究· 股深动脉优势供血治疗TASC D型动脉硬化下肢缺血的疗效分析 田 轩，刘建龙*，贾 伟，蒋 鹏，程志远，张蕴鑫，田晨阳 （北京积水潭医院血管外科，北京 100029） 【摘 要】目的 探讨髂动脉通畅的泛大西洋学会联盟（TASC） D型动脉硬化下肢缺血，比较股浅动脉支架植入术与股深动脉成形术的疗效。方法 回顾性分析2007年1月至2010年12月北京积水潭医院血管外科收治的32例TASC D型下肢缺血患者临床资料，随机分为股浅动脉治疗组（行股浅动脉球囊扩张+支架植入术）和股深动脉治疗组，并进行配对对照分析。通过对比手术前后踝肱指数（ABI）、手术后3年截肢率及症状改善情况评估疗效，评价两种方法的疗效。结果 两组手术前后踝肱指数（ABI）均明显高于术前（P＜0.05）；且股浅动脉治疗组术后ABI高于股深动脉治疗组（P＜0.05）。两组3年后跛行距离＜200米和行截肢手术患者比较，差异均无统计学意义（P＞0.05）。结论 髂动脉通畅的TASC D型动脉硬化下肢缺血患者，无论腔内开通股浅动脉还是股深动脉成形均可改善患者症状，增加肢体血供；股浅动脉支架植入对患者近期远端肢体血供改善优于股深动脉成形术。 【关键词】股浅动脉硬化闭塞；股深动脉；支架植入；股深动脉成形术 【中图分类号】 R658.3 【文献标识码】 A 【DOI】 ? The efficacy of profunda femoris artery revascularization on the type D TASC atherosclerosis obliterans TIAN Xuan, LIU Jian-Long*, JIA Wei, JIANG Peng, CHENG Zhi-Yuan, Zhang Yun-Xin, TIAN Chen-Yang (Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China) 【Abstract】 Objective To compare the efficacy of revascularization of profundafemoris artery versus superficial femoral artery on the type D TASC atherosclerosis obliterans. Methods This was a retrospective study on 45 cases of type D TASC atherosclerosis obliterans treated at Beijing Jishuitan Hospital from January 2007 to December 2010. A total of 29 patients received endovascular balloon dilation combined with stent implantation into superficial femoral artery. Among those patients, revascularization of profundafemoris artery was performed in 16 subjects and revascularization of homolateral iliac artery was performed in 12 cases. The efficacy variables include ABI, amputation rate in the 3 years follow up, and the relief of symptoms. The final analysis was conducted in 32 paired cases. Results In the 16 patients treated with revascularization combined with stent insertion, ABI increased significantly after surgery (0.88 ?.09 vs 0.53?.133, Pim＜0.05). A total of 3 patients undergone amputation in the 3 years follow up. Nine patients had claudication after walking for less than 200 meters. In the prof