Deep球囊PTA治疗下肢动脉流出道硬化闭塞症

Treatment of arteriosclerosis obliterations on outflow tract of lower extremity artery by PTA with Deep balloon catheters

目的探讨Deep球囊经皮腔内血管成形术(PTA)微创治疗下肢动脉流出道硬化闭塞症的疗效。方法Deep球囊PTA治疗下肢动脉流出道硬化闭塞症26条肢体,观察其即时成功率,多普勒超声随访已治疗处再闭塞率,对治疗前后的踝/肱指数(ABI)、趾端皮肤温度(TTS)以及流出道动脉造影显影分数(OTVC)采用方差分析进行比较。结果全组经Deep球囊PTA微创治疗的即时成功率为100%。与治疗前比较,治疗后第1个月ABI具有显著差异(P<0.05),第6个月ABI无显著差异(P>0.05),但TTS有显著差异(P<0.05),第6个月下肢动脉流出道已闭塞的12条肢体的OTVC有显著差异(P<0.05)。下肢动脉流出道已治疗处1、3和6个月的再闭塞率分别为3.85%、38.46%和46.15%。结论采用Deep球囊PTA微创治疗下肢动脉流出道硬化闭塞症可促进动脉侧支血管生成,改善血供,提高TTS。

Objective To explore the treatment efficacy of percutaneous transluminal angioplasty （PTA） on arteriosclerosis obliterans of lower extremity outflow tract with Deep balloon catheters in minimal invasion. Methods Twenty-six legs with arteriosclerosis obliterans of outflow tract of lower extremity artery were treated by PTA with Deep balloon catheters. The immediate success rate was observed, and rate of re-obliteration was detected by Doppler ultrasound. Variance analysis was conducted for the comparison of ankle brachial index （ABI）, temperature of toes skin （TTS） and outflow tract of visualization score （OTVC） in arteriography before and after the treatment. Results The immediate success rate of the operations was 100%. Compared with those before the treatment, ABI of postoperative first month was significantly different （ P 〈 0.05 ） , while that of postoperative sixth month was not （ P 〉 0.05 ）. There were significant differences in TTS before the treatment and six months after the treatment（ P 〈0.05）. There were significant differences in OTVC in arteriography of those 12 cases with re-obliteration before the treatment and six months after the treatment （ P 〈 0. 05 ）. Rates of re- obliteration were 3.85% , 38.46% and 46.15% for the first, third and sixth month after the treatment. Conclusion PTA with Deep balloon catheters in the treatment of arteriosclerosis obliterans of lower extremity outflow tract can reconstruct the branches of arteries, improve the blood supply and raise temperature of ischemic toes.