内膜下血管成形术治疗下肢动脉硬化闭塞症的初期评估

Preliminary evaluation on subintimal angioplasty for the treatment of atherosclerosis obliteration in the lower extremities

目的初步评估内膜下血管成形术(subintimalangioplasty,SIA)在下肢动脉粥样硬化闭塞症治疗中的安全性和有效性。方法回顾性分析2003年12月至2005年3月期间施行SIA的15例患者临床资料,并将其与随机抽出的施行股动脉旁路转流术的11例患者进行对比研究。结果15例中11例(13条肢体)SIA操作成功,技术成功率为86.67%;术后踝肱指数(ankle-branchialindex,ABI)平均提高0.386,与术前ABI对比差异有统计学意义(P<0.05),术后临床症状均有明显改善。11例股动脉旁路转流术后1周ABI与术前ABI的平均差值(0.466±0.046)与11例SIA操作成功的术后1周ABI与术前ABI的平均差值(0.386±0.027)进行团体t检验,差异无统计学意义(P>0.05)。SIA术后6个月,治疗动脉的通畅率为81.82%。结论操作成功的SIA的近期治疗效果与旁路转流术的近期治疗效果相近。SIA用于治疗短段或长段动脉粥样硬化闭塞症,具有很好的安全性及有效性,近期疗效令人满意。

Objective To evaluate the safety and validity of subintimal angioplasty （SIA） for the treatment of atheroschrosis obliteration （ASO） in the lower extremities. Methods The data of 15 cases treated with SIA between December 2003 and March 2005 were retrospectively analyzed, and compared to those of 11 cases treated with bypass operation. Results There was significant difference in ankle- branchial index （ABI） before and after SIA （ P 〈 0.05）. The successfttl rate of SIA was 86.67 %, and the patency rate 6 months after SIA was 81.82 %. No significant difference was found in the increased ABI average values one week after SIA in comparison to that after bypass operation （ P 〉 0.05）. Conclusion The short - term therapeutic validity of SIA is similar to that of bypass operation, SIA has a good safety and validity in the treatment of ASO in the lower extremities.