腔内血管成形术治疗膝下动脉缺血的临床研究

The study on percutaneous transluminal angioplasty for infrapopliteal arterial occlusive disease

目的评价腔内血管成形术(PTA)治疗膝下动脉闭塞性疾病的疗效及通畅情况。方法对47例(54肢)膝下动脉缺血患者进行膝下动脉缺血PTA,将其治疗前后踝肱指数(ABI)、治疗后临床疗效及动脉通畅率等进行统计学分析。结果全组术前ABI平均值为0.34±0.04;术后14天为0.86±0.03。本组无围手术期死亡,术后并发症发生率为7.7%,其动脉累积通畅率1年、2年一期通畅率分别为88.5%及65.2%;二期通畅率分别为96.2%及83.3%;救肢率为100%。结论 PTA作为膝下动脉缺血的治疗方法是可行、安全、有效的,推荐PTA作为首选的治疗方法,其长期通畅性有待进一步观察。

Objective To evaluate the clinical results and the arterial patency of infrapopliteal artery after percutaneous transluminal angioplasty(PTA).Methods PTA were performed on 47 patients(54 limbs) with infrapopliteal artery ischemia.ABI,clinical results and cumulative patency were collected and analyzed statistically.Results In this study,the average pre-therapeutic ABI is 0.34±0.04;the average ABI increased to 0.86±0.03 at 14-day after-therapy,and ABI increased by 0.52±0.04 averagely.There were no patient deathes during the peri-therapeutic period.The postoperative complication rate was 7.7%.The arterial cumulative patency rate was 88.5% at 1-year,65.2% at 2-year postoperatively,respectively.The secondary arterial patency rate was 96.2% at 1-year,83.3% at 2-year postoperatively,respectively.The limb salvage rate was 100%.Conclusion PTA is a feasible,safe,and effective procedure,and it should be recommended as the first choice for all patients with critical infrapopliteal limb ischemia.But the long term patency needs to be observed in the future.