支架植入术联合取栓术治疗长段髂动脉闭塞

Combining stenting and thrombectomy to treat long-segment iliac artery occlusive disease

目的探讨支架植入术（PTA）联合取栓术治疗长段髂动脉闭塞的临床应用价值。方法回顾性分析2005年7月至2007年10月哈尔滨医科大学附属第二医院血管外科应用PTA联合取栓术治疗长段髂动脉闭塞26例病人的临床资料。结果24例病人成功行PTA联合取栓术，2例由于动脉管腔完全硬化闭塞而无法行介入手术，技术成功率为92．3％。有3例同时行对侧髂动脉PTA。术后病人症状均有明显改善或消失，围手术期无死亡。踝肱指数（ABI）平均增加0．52。随访4～30个月，平均22个月。4例病人分别于术后25d和40d及12和21个月再次出现下肢缺血症状，给予对症治疗后症状改善。结论PTA联合取栓术治疗长段髂动脉闭塞安全、疗效肯定，但应掌握其适应证，远期疗效需进一步观察。

Objective To explore the clinical application of combining stenting and thrombectomy to treat long-segment iliae artery occlusive disease. Methods The clinical data of 26 patients with long-segment iliae artery occlusive disease performed by stenting and thrombectomy between July 2005 and October 2007 were analyzed retrospectively. Resnits Twenty-four patients were treated by stenting and thrombectomy successfully. Two patients failed and 3 patients were treated by stenting the opposite iliae artery simultaneously. The patients＇ symptoms were relieved obviously, even disappeared. The mean ankle brachial index （ ABI ） increased 0. 52. They were followed-up for 4 - 30 months. There were 4 patients recurred in 25d ,40d, 12 and 21months respectively and symptoms were relieved by symptomatic treatment. Conclusion Combining stenting and thrombectomy can be a safe and effective method in treating long-segment iliae artery ocelusive disease. But it will be necessary to control its indication and observe long-term therapeutic effect.