经皮腔内介入治疗急性肱动脉损伤26例

Percutaneous endovascular treatment for acute brachial artery injury:clinical results of 26 cases

目的探讨经皮腔内介入治疗急性肱动脉损伤的临床疗效。方法回顾性分析2005年1月至2014年2月期间收治的26例急性肱动脉损伤患者资料。经股动脉入路,造影证实肱动脉闭塞,明确血管闭塞的范围及程度。顺行开通失败时,穿刺患侧桡动脉,运用双向内膜下血管再通技术,建立工作导丝通道,然后行球囊扩张术及支架植入治疗。结果 26例急性肱动脉损伤患者手术成功率100%,随访6~36个月,26例中21例血管保持通畅,5例支架出现狭窄,立即行球囊扩张术,经造影血流迅速恢复通畅,26例中无一出现缺血坏死,截肢的情况。结论经皮腔内介入治疗急性肱动脉损伤,能够迅速开通肱动脉,恢复血流,临床效果显著。

Objective To investigate the clinical effect of percutaneous endovascular treatment for acute brachial artery injury. Methods The clinical data of 26 patients with acute brachial artery injury, who were treated at authors＇ hospital during the period from January 2005 to February 2014, were retrospectively analyzed. Brachial artery occlusion was proved by angiography via femoral access, and the extent and degree of arterial obstruction were verified. The radial artery of the affected side was punctured when antegrade recanalization of the occlusion failed. By using bidirectional subintimal reeanalization technique, the working guide wire channel was established, which was followed by balloon dilatation and stent implantation. Results Technical success rate was 100%. All the 26 patients were followed up for 6-36 months, among whom vascular patency was kept in 21 and stent stenosis was observed in 5, for these patients balloon dilation had to be carried out immediately and the blood flow returned to normal rapidly. During the follow-up period, no ischemic necrosis occurred and no amputation surgery was needed. Conclusion In treating acute brachial artery injury, percutaneous endovascular therapycan quickly open the brachial artery lumen and restore the blood flow, the clinical effect is very significant.（J Intervent Radiol, 2017, 26： 69-72）