摘要
目的回顾性分析使用长球囊经皮腔内血管成形术(PTA)治疗糖尿病严重下肢缺血的安全性和疗效。方法从2007年4月到2008年3月,34例患者(53条下肢,119处血管病变)接受了长球囊膝下血管PTA。回顾性分析血管造影图像,根据病变长度和程度进行分类和分级。平均随访期(7.4±2.6)个月,随访期内每3个月进行1次下肢MRA,并收集相关临床资料。结果 92%患者手术成功。踝肱指数(ankle-brachial index,ABI)和经皮氧分压(transcutaneous oxygen tension,TcPO2)分别从治疗前的(0.50±0.18)和(18.85±12.08)mmHg,提高到治疗后的(0.81±0.12)和(39.85±12.67)mmHg。在随访期末,29例患者取得稳定疗效。5例症状复发,其中3例行第2次PTA。共进行了2例大截肢和4例小截肢术,取得94%的保肢率和59%的通畅率。结论使用长球囊行膝下动脉PTA治疗糖尿病严重下肢缺血安全、可行,取得令人鼓舞的中期效果,需要更深入的研究来评估其长期效果。
Objective To retrospectively evaluate the safety and efficacy of percutaneous transluminal angioplasty(PTA)by using a long over-the-wire(OTW)balloon for the treatment of severe limb ischemia in diabetic patients.Methods During the period from April 2007 to March 2008,infrapopliteal PTA by using a long OTW balloon was performed in 34 patients.The patients,with a mean age of(71.8 ± 7.4)years,had 53 affected limbs with a total of 119 vascular lesions.All patients presented with a chief complaint of limb ischemic symptoms.Angiographic findings were retrospectively analysed and the lesions were categorized according to the length and severity.The mean follow-up period was(7.4 ± 2.6)months.Magnetic resonance angiography(MRA)of the lower limb was conducted every three months during the follow-up period,and the clinical data were collected and analysed.Results Infrapopliteal PTA by using a long OTW balloon was successfully carried out in 92.4% of vascular lesions(110/119).Ankel-brachial index(ABI)and transcutaneous oxygen tension(TcPO2)were improved from preoperative(0.50 ± 0.18)and(18.85 ± 12.08) mmHg to postoperative(0.81 ± 0.12)and(39.85 ± 12.67) mmHg,respectively.At the end of follow-up,29 patients maintained a stable outcome.Recurrence of symptoms were seen in five patients,and three of them had to receive a second PTA.Although two major amputations and four minor amputations had to be done,94% limb salvage rate and 59% patency rate were obtained.Conclusion Infrapopliteal PTA by using a long OTW balloon for the treatment of severe limb ischemia in diabetic patients.is clinically feasible and safe.Its midterm outcome is satisfactory and encouraging although its long-term effect needs to be evaluated with further study.
出处
《介入放射学杂志》
CSCD
北大核心
2011年第3期191-195,共5页
Journal of Interventional Radiology
基金
上海市科委医学引导项目(10411966700)
关键词
血管成形术
球囊
糖尿病足
膝下动脉
angioplasty
balloon
diabetic foot
infrapopliteal artery