弹簧支架在下肢动脉硬化性狭窄和闭塞治疗中的应用

Treatment of arteriosclerotic stenoses and occlusions of femoropopliteal arteries with introcoil stent

目的总结使用弹簧支架对下肢动脉硬化性狭窄和闭塞行介入球囊扩张、支架术的临床经验和近、远期疗效。方法对23例患者的29条肢体的下肢动脉硬化性病变行球囊扩张后置入弹簧支架(Introcoil)。结果成功完成29条肢体的治疗,无术中并发症。置入后即时造影示病变处管径明显增大,血流通畅。所有患者均获2-36个月随访,平均随访20个月。6例患者的6条肢体(20．7％)因重新出现动脉闭塞而行搭桥手术,其他患者下肢原有症状消失,20条足背动脉搏动恢复,超声示支架处血流通畅。结论弹簧支架置入是一种有效的下肢动脉狭窄和闭塞的介入治疗方法。

Objective To evaluate the efficacy of introcoil stent in the treatment of arteriosclerotic stenoses and occlusions of femoropopliteal arteries. Methods In this study, 29 limbs in 23 patients （ 17 males, 6 females, ages 49 to 78 ） with arteriosclerotic stenosis （24 limbs ） or occlusion （5 limbs ） of femoropopliteal arteries were treated by PTA and placement of introcoil stent. Follow-up surveillance featured periodic physical examination and duplex scanning. Results The procedure was successful in all 29 limbs without major complications. Six cases each used 2 stents. Angiography after stenting showed that the treated vessels were all patent. All patients were followed up from 2 to 36 months （ mean 20 months）. Symptoms disappeared and vessels were patent except for that of 6 limbs （ 20. 7% ） of which the vessels became occluded and graft bypass was needed. Condusions Introcoil stent implantation is a promising technique in the management of femoropopliteal arteriosclerotic lesions, especially of lesions near the joint.