严重下肢缺血的腔内血管介入治疗体会

Endovascular Interventional Therapy on Critical Limb Ischemia

目的:探讨严重缺血下肢的腔内血管治疗的可行性、优越性。方法:29例严重缺血下肢患者,Fontaine分期:Ⅲ期22例,Ⅳ期7例,术前行多普勒彩超、CT血管造影(CTA)或磁共振血管造影(MRA)检查,选择顺或逆行股总动脉穿刺,数字减影血管造影(DSA)机下行下肢动脉经皮腔内血管成形术(PTA)+支架成形术或置管溶栓后再PTA。结果:29例病人技术成功率100%,截趾率10.34%,保肢率96.55%,下肢皮温变暖,行走功能明显改善。结论:腔内血管介入治疗因为微创、可重复性强、病人身体条件易承受、保肢率高,应成为恢复严重下肢缺血血供的首选治疗手段。

Objective： To investigate the feasibility of interventional therapy on critical limb ischemia.Methods： Twenty-nine patients with critical limb ischemia included 22 cases in period Ⅲ and 7 cases in period Ⅳ according to the Fontaine staging underwent examination of Doppler ultrasonography,CTA,or MRA before operation.All the patients were carried out percutaneous transluminal angioplasty and stenting（PTAS） or PTA after thrombolysis.Results： All 29 patient were successfully treated,the toe amputation rate was only 10.34%,the limb salvage rate was 96.55%,and the limb function was improved.Conclusion： To the patients with critical limb ischemia,interventional therapy is a preferred method for reconstruct limb blood supply.