切割球囊处理下肢动脉支架术后再狭窄的临床应用

Cutting balloon used to manage post-stenting restenosis in lower limb arteries

目的观察切割球囊处理下肢动脉支架术后再狭窄的临床效果，评价其应用价值。方法对28例下肢动脉支架术后再狭窄的患者，选择对侧股动脉穿刺或同侧股动脉逆行穿刺，在导引钢丝通过病变后，根据血管大小选择合适切割球囊10～14atm扩张再狭窄病变1—3次，术后及6个月随访评价其治疗效果。结果28例患者，27例（96，42％）患者手术成功，除1例（3，57％）患者出现假性动脉瘤外，无严重并发症发生。6个月随访，24倒（85．71％）患者缺血症状明显改善，22例（81．48％）血管处于开放状态，7例（25．92％）患者切割球囊术后狭窄。结论切割球囊处理下肢动脉支架术后再狭窄安全、可靠、再狭窄率较低，有较高的临床应用价值。

Objective To evaluate the clinical effect of cutting ballon used to manage post-stenting restenosis in lower limb arteries. Methods Twenty-eight patients in Severance Hospital, who had restenosis of lower limb arteries after stenting, underwent puncturing from opposite femoral artery or retrograde puncturing of ipsilateral femoral artery. After the guiding wire got through the lesion successfully, suitable cutting balloon was used to expand the restenosis at the site of stent for 1 - 3 times. The patients were followed up after operation and at the sixth month from ballooning. Results Of the 28 patients, except 1 pseudoaneurysm, 27 （96.42%） had the procedure carried out successfully. During the 6 months of following up, 24 （85.71% ） patients＇ ischemic symptoms ameliorated, 22 （81.48 % ） patients＇ arteries were patent, 7 （25.92 % ） patients suffered from restenosis. Conclusion Cutting balloon was safe and reliable when used to manage post-stenting restenosis in lower limb arteries and caused a relatively low rate of restenosis.