血管腔内技术治疗下肢动脉硬化闭塞疾病

Endovascular treatment for lower extremity atherosclerotic occlusive disease

目的：评价经皮血管腔内球囊扩张成形术（PTA）和支架置入（PTAS），治疗下肢动脉硬化闭塞症（LEAOD）的临床效果和应用价值。方法：169例下肢动脉硬化闭塞症接受了经皮血管腔内PTA和PTAS。结果：全组治疗成功率97．63％（149／169），除4例LEAOD患者支架置入失败外，其余病例均治疗成功，临床症状消失或好转，踝／肱指数（ABI）由0．1～0．59，平均（0．37±0．19）上升为0．69—1．16（平均0．88±0．17），两者比较差异有统计学意义（P〈0．05）。术后随访360个月，仅统计6、12、36、60个月的通畅率，68例髂动脉为：98．53％、92．65％、91．18％、89．71％；60例股浅动脉中、上2／3段阻塞为：91．67％、86．67％、81．67％、73．33％；41例股浅动脉下1／3段阻塞为：85．37％、78．05％、68．29％、56．09％。结论：经皮血管腔内PTA和PTAS治疗LEAOD，可使闭塞血管得到长期的有效开通，显著提高血流动力学指标，是安全有效的治疗方法。

Objective：To study the clinical effect and applied value of pereutaneous transluminl angioplasty（PTA） and pereutaneous transluminl angioplasty and stenting（FFAS） on lower extremity atherosclerotie occlusive disease（LEAOD）. Methods：Pecutaneous translumlnl angloplasty and stenting treatment was performed in 169 attherosclerosis obliterans LEAOD patients. Results： Total achievement ratio was 97.63% （149/169） .Except the PTAS treatment for4 LEAOD patients was failed, the others were doing well for clinical symptom disappear or better, whose average ankle brachlal index（ABI） were 0.11 - 0.58（0.37± 0.19） and 0.69 - 1.16（0.88 ± 0.17） respectively. The statistical results showed a significant difference in ABI （ P 〈 0.05）, follow-up for 3 - 60 months; The superficial femoral artery （68 patients in arteria iliaea, 60 patients in middle-upper 2/3 seginem of superficial femoral artery and 41 patients in meta-infero 1/ 3 segrnent） keep smooth blood stream with a proportion of 98.53%, 92.65%, 91.18%, 89.71%; 91.67%, 86.67%, 81.67%, 73.33 % ; 85.37 %, 78.05 %, 68.29 %, 56.09 % respectively, the time of follow-up was 6, 12, 36 and 60 months. Conclusion： The PLA and PTAS treatment for LEAOD was a safe and effective option, which could make obstructed blood vessel long-term enlighten in effect and remarkably raise the haemodynamics index.