镍钛合金支架治疗长段股动脉完全闭塞的技术和结果

Nitinol stents implantation in long and total occlusion of superficial femoral artery:technique and preliminary study

目的评价长段股浅动脉(SFA)完全闭塞镍钛合金支架的治疗方法及有效性。方法20例患者,男12例,女8例。年龄42～85岁(平均64.1岁)。均有病变侧下肢间歇性跛行。共26条SFA(左侧16条,右侧10条)完全闭塞,闭塞长度11～38cm(平均28.2cm)。治疗方法包括:导丝开通、球囊导管扩张(PTA)和自张式镍钛合金支架置入。结果19例25条SFA获得开通(开通成功率96.2%)。支架置入后,25条SFA均获得通畅,相应下肢缺血症状均明显减轻或消失。19例随访(1～26个月,平均8.7个月)。2例分别于术后8、20个月各1条SFA闭塞,经溶栓和PTA后均再次获得通畅。余17例均无下肢缺血症状发生,其中12例超声Doppler检查,SFA均有血流通过。结论多种介入技术结合可有效开通长段闭塞SFA;镍钛合金支架有利于保持SFA通畅,治疗下肢动脉缺血。

Objective To evaluate the technique and the efficacy of intervention for total and long occlusion of superficial femoral artery （SFA）. Methods Twenty patients （male 12,female 8） with 26 total and long occlusion of superficial femoral arteries aged from 42 to 85 years old （mean 64.1 years old） and all had intermittent claudication in lower extremities. The lengthy of occlusion was from 11 cm to 38 cm longer （mean 28.2 cm）. The interventional methods included guidewire canalization, percutaneous transluminal angioplasty （PTA） and Nitino alloy stent implantation. Results Twenty five occlusive SFAs in 19 patients were successfully canalized. The occlusive SFAs got reopen by PTA followed by stent implantation and patients symptom alleviated. During the follow-up from 1 month to 26 months （mean 8. 7 months）, 17 patients still had a better blood flow checked by Doppler. There were two SFAs in two patients occluded at the 8th month and 20th month respectively, hut received the second successful PTA and thrombolysis. Conclusion Compound interventional technique can make the long and total occluded SFA reopen, and Nitino alloy stent can effectively resolve the ischemia in lower extremity.