激光辅助球囊血管成形术治疗膝下动脉硬化闭塞症合并严重肢体缺血的临床研究

Laser-assisted balloon angioplasty for infrapopliteal arterial occlusion with critical limb ischemia:a clinical study

目的 评价激光辅助球囊血管成形术(LABA)治疗膝下动脉硬化闭塞症合并严重肢体缺血(CLI)患者的临床疗效及安全性。方法 回顾性分析2019年1月至2021年12月阜外华中心血管病医院采用LABA或单纯球囊血管成形术(BA)治疗膝下动脉硬化闭塞症合并CLI患者的临床资料,比较两组患者围手术期并发症发生率及术后临床疗效。结果 32例患者行LABA治疗,40例患者行单纯BA治疗。LABA组技术成功率、术后踝肱指数(ABI)、术后ABI较术前提高值、术后24个月临床症状持续改善率和靶血管一期通畅率均高于单纯BA组(均P<0.05)。两组患者均未发生手术相关的靶血管穿孔、截肢及死亡事件,在靶血管动脉夹层、远端栓塞、补救性支架置入及术后24个月免截肢生存率等方面均无统计学差异(均P>0.05)。结论 LABA治疗膝下动脉硬化闭塞症合并CLI安全有效,中期疗效优于单纯BA。

Objective To evaluate the efficacy and safety of laser-assisted balloon angioplasty(LABA) in treating patients with infrapopliteal arterial occlusion complicated by critical limb ischemia(CLI).Methods The clinical data of patients with infrapopliteal artery occlusion complicated by CLI,who were admitted to the Fuwai Central China Cardiovascular Hospital to receive LABA(LABA group) or balloon angioplasty alone(BA group) between January 2019 and December 2021,were retrospectively analyzed.The incidence of perioperative complications and postoperative clinical efficacy were compared between the two groups.Results A total of32 patients received LABA therapy and 40 patients received BA alone.The technical success rate,the postoperative ankle-brachial index(ABI),the numerical value of postoperative ABI value deducting preoperative ABI value,the postoperative 24-month continuous improvement rate of clinical symptoms and the primary patency rate of target vessels in the LABA group were remarkably higher than those in the BA group(all P<0.05).No procedurerelated target vessel perforation,amputation,or death occurred in both groups.No statistically significant differences in the target vessel dissection,distal embolism,remedial stenting,and postoperative 24-month amputation-free survival existed between the groups(all P>0.05).Conclusion For the infrapopliteal arterial occlusion complicated by CLI,LABA therapy is clinically safe and effective,and its mid-term efficacy is superior to BA alone.(J Intervent Radiol,2024,32:130-134)