髂-股联合闭塞性疾病腔内治疗的技术探讨和疗效观察

Technical exploration and efficacy observation of endovascular treatment for iliac-femoral multisegmental artery occlusive disease

目的:评价髂股动脉联合硬化狭窄,闭塞性疾病腔内治疗的安全性,临床成功率和短期通畅率。方法:2005年5～12月,19例髂股动脉联合病变的患者接受了腔内治疗,其中严重跛行(fontainⅡb)15例,静息痛3例,溃疡1例。髂动脉完全闭塞8例,严重狭窄(≥50%)11例。股总动脉严重狭窄或闭塞3例,股浅动脉狭窄6例闭塞13例。全部病例均采用对侧股动脉逆行入路跨过主动脉分叉对患侧髂股动脉行腔内治疗。结果:本组病例无围手术期死亡,总的并发症发生率5.2%(1例支架内血栓形成),技术成功率100%,平均随访5.5个月(1～8个月)短期随访腔内治疗通畅率为89%(17/19)。结论:对于导致严重下肢缺血的髂股联合硬化闭塞性病变的腔内治疗是一安全、可靠易行的微创手段,具有良好的短期临床效果,但其中、远期疗效确有待进一步观察。

Objectlve：To evaluate the safety, clinical success rates, and short-term patency in patient with iliac artery and femoral muhisegmental artery occlusive disease. Methods：Nineteen patients with iliac artery and femoral muhisegmental artery occlusive disease were treated with endovascular therapy. The patients had chronic limb ischemia described as disabling claudication （fontain Ⅱ b）in 15cases, restpain in 3 cases, ulcer in 1 case. The affected arteries receiving treatment included 8 iliac arteries with complete occlusion and 11 iliac arteries with critical stenosis （≥50%）, 3 common femoral arteries with complete occlusion or critical stenosis, 6 superficial femoral arteries with complete occlusion, 13 superficial femoral arteries with critical stenosis. Endovascular procedures were performed using introducer sheaths from contralateral femoral artery via aorta crotch to occlusive iliac artery. Results：There was no perioperative death. Total complication rate was 5.2%（one thrombosisn in stent）, and the technical success rate was 100%. The mean follow-up time was 5.5 months（range, 1 to 8 months）. The patency rate was 89%（17/19）. Conclusion：Endovascular therapy of iliac and femoral muhisegmental artery occlusive disease is safe, convenient and effective, but the long-term curative effect need to be confirmed.