下肢闭塞性动脉粥样硬化血管成形及支架植入术的临床研究.docVIP

PAGE PAGE 4 下肢闭塞性动脉粥样硬化血管成形及支架植入术的临床研究 彭 锦，迟路湘 （400038 重庆，第三军医大学西南医院心血管内科） [摘要] 目的　评估下肢闭塞性动脉粥样硬化血管成形及支架植入术治疗的疗效及安全性。方法　20例（34处病变）均为间歇性跛行及静息痛患者，病因均为动脉粥样硬化。病变位于髂动脉18处，位于股腘动脉12处，位于腘下动脉4处。髂、股腘动脉病变均先行球囊血管成形术，如果有夹层或残余狭窄30%，则植入支架；腘下动脉病变仅行球囊血管成形术。随访6个月和12个月时评估再狭窄和临床疗效。结果 20例（34处病变）均介入成功，下肢缺血症状均明显减轻或消失。6个月随访，再狭窄率在髂动脉、股腘动脉、腘下动脉分别为5.5%、16.7%、25.0%；12个月随访，再狭窄率在髂动脉、股腘动脉、腘下动脉分别为11.1%、33.3%、75.0% 。结论　血管成形及支架植入术治疗下肢闭塞性动脉粥样硬化安全有效，术后规范抗血小板、抗凝、抗脂治疗对于保持血管再通至关重要。 [关键词] 动脉硬化, 闭塞性；下肢；血管成形术；支架 ADDIN EN.REFLIST [中图法分类号] [文献标志码] A Clinical research of angioplasty and stent implantation in the treatment of lower limb atherosclerosis obliterans Peng Jin，Chi Luxiang (Department of Cardiovasology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China) ［Abstract］Objective To assess efficacy and safety of angioplasty and stent implantation in the treatment of lower limb atherosclerosis obliterans. Methods 20 patients (34 lesions) with lower limb atherosclerosis obliterans were treated by angioplasty and stent implantation, which 18 cases occlusion in iliac artery, 12 cases in femoral popliteal artery and 4 cases in inferior genicular artery. The iliac artery and femoral popliteal artery lesions were first carried out balloon angioplasty, if there is mezzanine or residual stenosis 30%, then stenting; the inferior genicular artery lesions only were carried out balloon angioplasty.Followed up for 6 months and 12 months to assess of restenosis and clinical efficacy. Results All the patients’ therapy was successful，their clinical symptoms were improved or disappeared. 6-month follow-up revealed restenosis rates in the iliac artery and femoral popliteal artery, inferior genicular artery were respectively 5.5%, 16.7%, 25%; 12-month follow-up revealed restenosis rates were respectively 11.1%, 33.3%, 75%. Conclusion angioplasty and stent implantation are safe and effective in treatment of ower limb atherosclerosis obliterans. standardized pos