36例下肢动脉硬化闭塞症的介入治疗及疗效观察

Interventional therapy and its efficacy for lower extremity arteriosclerosis occlusive disease of 36 cases.

目的探讨经皮腔内球囊扩张血管成形术（PTA）及血管内支架治疗下肢动脉硬化闭塞症的临床应用价值。方法总结2008年1～12月应用PTA结合血管内支架成形术治疗36例（41条患肢）下肢动脉硬化闭塞症的效果。结果胛A即时成功率95．1％（39／41），37条肢体术后临床症状明显改善；2条无明显改善，其中1条术后截肢。临床表现为下肢疼痛消失，皮肤温度变暖，溃疡趋于愈合，踝肱指数由术前0．54±0．1I恢复至0．79±0．15。经随访3—15个月，3条股动脉在术后5、6、12个月再次闭塞，1条胫后动脉在术后8个月再次闭塞，通畅率为89．7％（35／39）。结论PTA结合血管内支架置放有助于提高通畅率，操作简便、微创、安全，是治疗下肢动脉硬化闭塞症的有效方法。

Objective To explore the clinical application of percutaneous transluminal angioplasty （PTA） and endovascular bracket to treat lower extremity arteriosclorotic occlusion. Methods The clinical data of 36 patients （41 affected limbs） with lower extremity atherosclerotic occlusion who were treated with PTA and bracket implantation from Jan 2008 to Dec 2008 were summarized. Results The initial successful rate of PTA was 95. 1% （39/41）. The clinical symptoms were considerably improved in 37 affected limbs, representing of pain disappearing, skin temperature increasing and the healing of refractory ulcer. The index of ankle to brachial significantly increased from 0.54 ＋0. 11 to 0. 79 ±0, 15 （before v. s. after therapy）. However,no improvement was observed in 3 affected limbs, and one affected limb was re-operated by the amputation. In the following 3 to 15 months, three superficial femoral arteries were re-obstructed at the 5th ,6th, 12th month, respectively. One arteria tibialis posterior was re-obstructed at the 8th month. The cumulative cure rate was 89.7% （35/39）. Conclusions PTA is effective in treating atherosclerotic occlusive diseases. The endovascular bracket can increase the cumulative cure rate. PTA and endovascular bracket are safe and effective in treating lower extremity arteriosclerotic occlusion.