周围动脉疾患合并冠心病的介入治疗

Percutaneous intervention for treatment of peripheral artery stenosis and occlusion in patients with coronary artery disease

目的 探讨周围动脉疾患合并冠心病的介入治疗安全性和临床效果。方法 13例患者均施行了选择性冠状动脉造影及胸或腹主动脉造影。 18支周围动脉疾患中采用单纯球囊扩张术(PTA) 11支 ,支架置入术 5支 ,溶栓术 2支。结果 血管造影发现肾动脉狭窄 3例 (4支 ) ,髂动脉狭窄6例 (7支 ) ,右锁骨下动脉狭窄、右锁骨下动脉伴双肾动脉狭窄、左锁骨下动脉狭窄伴左髂动脉阻塞、左股动脉阻塞各 1例。合并冠心病左主干伴 3支病变 2例 ,3支病变 9例 ,2支病变和单支病变各1例。技术成功 17支 ,其中单纯球囊扩张术 11支 ,支架置入术 5支 ,溶栓术 1支。临床治愈 改善12例。除 1例冠状动脉造影后发生急性肾功能不全外 ,余无心脏并发症及与操作有关的并发症发生。结论 介入治疗合并冠心病的周围动脉疾患是安全、有效、可行的。

Objective To approach the safety and clinical results of percutaneous intervention for treatment of peripheral artery stenosis and occlusion in patients with coronary artery disease. Methods Coronary and thoracic or abdominal angiography were routinely performed in 13 patients. Balloon angioplasty was done in 11 arterial lesions, intravascular stent placement in 5, and intraarterial thrombolysis in 2. Results Angiographic findings in 13 patients showed that there were 3 cases with renal stenosis (4 lesions),6 with iliac artery stenosis (7 lesions), right subclavian stenosis, right subclavian and bilateral renal artery stenoses, left subclavian artery stenosis and left iliac artery occlusion, left femoral artery occlusion in 1, respectively. All patients had coronary artery disease. Of these, left main and 3 vessel in 2 cases, 3 vessel in 9, 2 vessel and 1 vessel in 1, respectively. The technical success was achieved in 17 lesions. 12 cases turned out to be clinically cured improved. No complications and cardiac events were encountered during or immediately after treatment procedure in this series, except 1 patient who developed acute renal insufficiency after coronary angiography. Conclusion Percutaneous intervention was safe, effective and feasible in treating peripheral artery stenosis and occlusion in patients with coronary artery disease.