PTA及血管内支架在治疗下肢动脉硬化闭塞症的应用价值

Application value of PTA and endovascular stent to treat arteriosclorotic occlusion lower extremities.

目的 探讨经皮腔球囊扩张血管成形术及血管内支架的临床应用价值。方法 总结 1993～ 1998年应用经皮腔球囊扩张血管成形及血管内支架移植治疗 2 1例 ( 2 5条患肢 )下肢动脉硬化闭塞症的效果。结果 PTA即时成功率 80 % ( 2 0 / 2 5 ) ,踝 /肱指数由术前 0 43± 0 12恢复至 0 76± 0 16。经随访 3～ 6 6个月 ,3条股浅动脉在PTA后 5年、3年、1年后再次闭塞 ,通畅率为 85 7% ( 18/ 2 1)。结论 经皮腔球囊扩张血管成形术是治疗下肢动脉闭塞性疾病的有效方法 ,血管内支架置放有助于提高通畅率。多平面、多节段动脉闭塞性病变联合手术重建 ,可简化手术操作 ,缩小手术创伤。

Objective To evaluate the effects of percutaneous transluminal angioplasty (PTA) and endovascular stent implantation for the treatment of atherosclerotic occlusive lower limbs.Methods We summarized the clinical data of 21patients (25 limbs) with atherosclerotic occlusive lower limbs who were treated with PTA and stent implantation from 1993～1998.Results Pre-treatment ankle/brachial index of 0 43±0 12 increased to 0 76±0 16 after PTA,and the initial successful rate of PTA was 80%(20/25).The follow-up period ranges from 3 to 66 months,all except three limbs with re-obstruction after 1,3,5 year,respectively,were in excellent results.The cumulative patency rate is 85 7%(18/21).Conclusion PTA is an effective method for managing patients with atherosclerotic occlusive disease.The stent insertion can prevent re-obstruction due to elastic recoil of the vessel.Combination of PTA and surgical revascularization is recommended for high-risk patients with severe multi level atherosclerotic lesions.