TASCC、D级髂动脉病变的腔内治疗

Endovascular therapy for TASC-C/D lesions of iliac artery occlusions

目的探讨腔内技术治疗TASCC、D级髂动脉病变的可行性及近期疗效。方法回顾性总结77例TASCC、D级(共89条髂动脉)行腔内治疗患者的临床资料;其中TASCC级病变63例,TASCD级病变14例。结果 3条髂动脉未能开通闭塞段,开通率为96.6%。23条髂动脉行单纯经皮血管腔内成形术治疗,其余63条髂动脉置入支架。共置入支架104枚。踝肱指数由术前0.20±0.14增至术后7天的0.71±0.21(P=0.02)。主要并发症发生率3.9%。64例(78条髂动脉)患者获得随访,随访率83.1%;平均随访时间23(6～53)个月,其1、2、4年肢体通畅率分别为88%、84%和70%。结论腔内治疗TASCC、D级髂动脉病变安全微创,其短期效果较好。

Objiective To evaluate the feasibility and efficacy of endovascular therapy for TASC-C/D lesions of iliac artery occlusions.Method The data of 77 patients(89 limbs) who underwent endovascular therapy for TASC-C/D lesions of iliac artery occlusions were reviewed retrospectively.Results Three limbs failed to recanalize the occlusions,recanalization rate was 96.6%.Twenty-three iliac artery were successfully treated by percutaneous transluminal angioplasty,and 63 by endovascular stentings,104 stents were implanted.The ankle-brachial index increased from preoperative 0.20±0.14 to 0.71±0.21 on the 7th day after operation(P=0.02).The main complications rate was 3.9%.Sixty-four patients(78 iliac arteries) were followed up for a mean time of 23 months(range,6-53 months),the follow-up rate was 83.1%.The limb patency rates of 1 year,2 and 4 years was 88%,84% and 70%,respectively.Conclusion Endovascular therapy for TASC-C/D lesions of iliac artery occlusions can be safe,microinvasive and has an optimistic short-term outcome.