下肢动脉硬化闭塞症腔内治疗后支架内再狭窄的治疗

Treatment of in-stent restenosis after endovascular treatment of arteriosclerosis and occlusion of lower extremity

目的探讨下肢动脉硬化闭塞症腔内治疗后支架内再狭窄(ISR)的治疗。方法选取福建医科大学附属漳州市医院2017年6月至2018年6月诊治的10例下肢动脉硬化闭塞症患者,共13条肢体。患者均行球囊扩张血管成形术,术后存在残余血栓予置管溶栓术。结果本组病例均接受腔内治疗,均球囊扩张后置管溶栓。治疗后患者症状均有不同程度缓解,术后平均踝肱指数(ABI)较术前明显升高(P<0.05)。随访7~16个月,平均(9.2±1.5)个月,3条肢体出现再狭窄,狭窄率约23.1%,均再次球囊扩张血管成形术联合置管溶栓术,未出现截肢及死亡病例。结论球囊扩张血管成形术联合置管溶栓术治疗下肢动脉硬化闭塞症腔内治疗后支架内ISR可取得满意的疗效。

Objective To explore the treatment of in-stent restenosis(ISR) after endovascular treatment for lower extremity arteriosclerosis obliterans. Method Ten patients with lower extremity arteriosclerosis obliterans, 13 limbs, were selected from Zhangzhou Hospital Affiliated to Fujian Medical University from June 2017 to June 2018. All patients underwent balloon angioplasty, and residual thrombosis was treated by catheter thrombolysis. Result All patients received endovascular treatment and were treated with balloon dilatation followed by catheter thrombolysis. After treatment, the symptoms of the patients were alleviated to varying degrees, and the average ankle-brachial index(ABI) after operation was significantly higher than that before operation(P<0.05). Follow-up for 7 to 16 months, with an average of(9.2±1.5) months, restenosis occurred in 3 limbs, with a stenosis rate of about 23.1%. All patients underwent balloon dilatation angioplasty combined with catheter thrombolysis, and no amputation or death occurred. Conclusion Balloon dilatation angioplasty combined with catheter-based thrombolysis for the treatment of lower extremity arteriosclerosis obliterans after endovascular treatment of ISR stent can achieve satisfactory results.