血管内支架置入治疗周围动脉硬化性闭塞疾病的探讨

Endovascular stent treatment for stenotic and occlusive lesions of peripheral artery

目的探讨血管内支架置入治疗周围动脉硬化闭塞疾病的临床效果和应用价值。方法1995年5月至2008年5月,161例周围动脉硬化性阻塞接受了局部溶栓+PTA+内支架置入。结果全组治疗成功率98.14%(158/161),53例髂动脉和25例锁骨下动脉,内支架置入治疗后随访时间>21个月,无一例临床症状复发;45例股浅动脉中、上2/3段阻塞,29例股浅动脉下1/3段和腘动脉阻塞,内支架置入治疗后随访时间>12个月,血流仍保持通畅分别为91.11%(41/45)和79 31%(23/29);9例肱动脉阻塞,支架置入治疗后随访时间超过3年,支架腔内血流均保持通畅。结论经皮经腔内支架置入治疗周围动脉急慢性闭塞疾病是安全有效的方法,首选充分的局部溶栓治疗,可显著提高PTA和内支架置入的成功率,减少并发症。

Objective To study the effect of endovascular stent implantation in treating stenotic and occlusive lesions of peripheral artery. Methods From May 1995 to May 2008, regional thrombolysis, PTA and endovascular stent were performed in 161 patients. Results Total achievement ratio was 98.14% （158/161）. Among them, endovascular stents were implanted into the stenotic and occlusive lesions of arteria iliaca （53 cases）, subclavical artery （25 cases） and there were no recurrence of clinical symptom after more than 21 months follow-up.12 months follow-up after implanting the stent into superficial femoral artery （45 cases in middle-upper 2/3 segment; 29 cases in meta-infer 1/3 segment and popliteal artery）, bloodstream kept smooth with a proportion of 91.11% （41/45） and 79.31% （23/ 29） respectively. The nine stents in occlusive brachial arteries were still patent even after more than 3 years＇ follow-up. Conclusion The percutaneous transluminal treatment was a safe and effective option. Sufficiently regional thrombolysis was the foundation of the treatment for the noticeable boost of achievement ratio and reducing complication of PTA and endovascular stent implantation.