介入治疗90岁及以上下肢动脉闭塞症患者的临床疗效

Clinical efficacy of interventional therapy for lower extremity arteriosclerosis obliterans in elderly patients aged≥90 years

目的探讨90岁以上下肢动脉闭塞症患者经皮下肢动脉腔内成形手术的临床疗效。方法选择2018年1月至2022年12月首都医科大学宣武医院收治的下肢动脉硬化闭塞症患者18例,均采用下肢动脉腔内成形术进行治疗。结果所有患者手术成功。16例患者手术前间歇性跛行距离为(125.56±119.77)m,手术后为(338.89±259.84)m(t=5.09,P<0.05);手术前踝肱指数为0.31±0.20,出院时踝肱指数为0.71±0.16(t=-11.52,P<0.05)。其中15例术后3个月Rutherford分级得到不同程度的提高,血管治疗长度[(250.45±213.50)mm]与Rutherford分级提升无相关性(P=0.703),而术后血管恢复比值(0.82±0.17)与Rutherford分级提升存在相关性(P=0.022)。结论介入治疗90岁及以上下肢动脉闭塞症患者的临床效果显著,能够保留患者部分自理能力,提高生活质量。

Objective To discuss the clinical effect of percutaneous endovascular angioplasty for lower extremity arteriosclerosis obliterans in elderly patients aged≥90 years.Methods A total of 18 elderly patients with lower extremity arteriosclerosis obliterans,who were admitted to Xuanwu Hospital of Capital Medical University to receive treatment from January 2018 to December 2022,were enrolled in this study.Percutaneous endovascular angioplasty was carried out for all patients.Results Successful percutaneous endovascular angioplasty was achieved in all patients.In 16 patients,the intermittent claudication distance increased from preoperative(125.56±119.77)m to postoperative(338.89±259.84)m(t=5.09,P<0.05).The ankle-brachial index(ABI)increased from preoperative(0.31±0.20)to(0.71±0.16)at the time of discharge(t=-11.52,P<0.05).In 15 patients,the Rutherford grade was improved to varying degrees in 3 months after surgery.The mean treated vascular length was(250.45±213.50)mm,which had no correlation with the improvement degree of Rutherford grade(P=0.703),but the postoperative vascular recovery ratio was well correlated with the improvement degree of Rutherford grade(P=0.022).Conclusion For lower extremity arteriosclerosis obliterans in elderly patients aged≥90 years,percutaneous endovascular angioplasty has excellent clinical effect,it can retain part of self-care ability and improve quality of life of patients.(J Intervent Radiol,2024,33:368-370)