髂动脉闭塞介入治疗的临床观察

Clinical observation on interventional treatment for the occlusion of iliac arteries

目的探讨髂动脉闭塞性病变介入治疗的技术要点。方法本组41例髂动脉闭塞的患者通过行闭塞段开通、经导管局部溶栓、血管腔内成形术(PTA)和内支架置入等多种介入方法综合治疗来观察效果。结果 41例患者介入治疗成功率达100%,治愈36例,好转5例,共9例血管闭塞者进行了溶栓治疗。术后随访2～24个月,平均18个月,除2例分别在术后11个月和8个月发生支架内再闭塞行二次介入治疗外,其余患者症状均无加重或复发。结论血管腔内介入治疗可作为治疗髂动脉闭塞可选择的手术替代方案,尤其是对于有高手术风险的患者,具有微创、简单、有效的优点。

Objective To explore the technical main points of interventional treatment for occlusion of iliac artery.Methods 41 patients with occlusion of iliac artery were treated by combined interventional techniques,such as recanalization,local thrombolysis via catheter,percutaneous transluminal angioplasty（PTA）,and implantation of stent.Results The patency was 100%,36 cases were recovery,5 cases were improved,local thrombolytic therapy in 9 cases.All the patients were followed up for 2～24 months（mean 18 months）.Among them,2 cases were treated again by interventional methods respectively at the 11 months and the 8 months for reocclusion of inner stents and symptoms in other cases showed no deterioration.Conclusion Percutaneous transluminal intervening therapy can substitute for the surgical operation for the treament of the occlusion of iliac arteries,which can provide a micro-trauma,a sample safe and effective method,particularly for patients with high surgical risk.