巧克力球囊(限制性扩张技术)用于腔内治疗下肢闭塞性动脉硬化前血管准备

Chocolate balloon(controlled dilatation technique)for vascular preparation of endovascular treatments for lower extremity arteriosclerosis obliterans

目的观察巧克力球囊(限制性扩张技术)用于腔内治疗下肢闭塞性动脉硬化(ASO)前血管准备的价值。方法回顾性分析110例接受巧克力球囊血管准备的下肢ASO患者资料,记录病变类型及钙化等,获取巧克力球囊血管准备成功率及腔内治疗ASO成功率。结果110例中,100例单侧、10例双侧存在下肢ASO病变,包括100处(100/120,83.33%)慢性闭塞性病变、8处(8/120,6.67%)狭窄病变及12处(12/120,10.00%)血栓病变;其中50处(50/120,41.67%)为3~4级钙化病变。腔内治疗前巧克力球囊血管准备成功率为92.50%(111/120);巧克力球囊扩张后7处病变(7/120,5.83%)因出现限流性夹层、2处(2/120,1.67%)因残余明显狭窄未达技术成功标准,直接植入支架而未使用药物涂层球囊(DCB);15处因DCB后出现限流性夹层而补救性植入支架。腔内治疗下肢ASO病变成功率100%。结论巧克力球囊(限制性扩张技术)用于腔内治疗下肢ASO前血管准备具有良好价值。

Objective To observe the value of chocolate balloon(controlled dilatation technique)for vascular preparation of endovascular treatments for lower extremity arteriosclerosis obliterans(ASO).Methods Data of 110 patients with lower extremity ASO who underwent vascular preparation with chocolate balloon were retrospectively analyzed.The type of ASO,with calcification or not and so on were recorded,and the success rate of vascular preparation with chocolate balloon and the therapeutic effect of endovascular treatments for ASO were evaluated.Results Among 110 patients,unilateral lower extremity ASO were found in 100 cases,while bilateral lower extremities ASO were noticed in 10 cases,including 100(100/120,83.33%)chronic occlusive lesions,8(8/120,6.67%)stenotic lesions and 12(12/120,10.00%)thrombotic lesions.Calcification with grade 3—4 were observed in 50 lesions(50/120,41.67%).The technical success rate of vascular preparation with chocolate balloon was 92.50%(111/120),while 7(7/120,5.83%)lesions developed flow-limiting dissection after chocolate balloon dilatation and 2(2/120,1.67%)lesions had significant residual stenosis that did not meet the technical success criteria,which underwent stent implantation without drug-coated balloon(DCB).Besides,flow-limiting dissection were noticed in 15 lesions after DCB,hence salvage stents were implanted.The success rate of endovascular treatments of ASO was 100%.Conclusion Chocolate balloon(controlled dilation technique)was valuable for vascular preparation of endovascular treatments for lower extremity ASO.