多入路联合介入治疗复杂主-髂动脉硬化性闭塞症

Multi-approach combining interventional therapy for treating complex aorta-iliac arteriosclerotic occlusion

目的：探讨多入路联合介入治疗技术在复杂主-髂动脉硬化性闭塞症的应用。方法选取2011年6月至2013年6月在空军总医院住院的复杂主-髂动脉硬化性闭塞症15例，男性12例，女性3例，年龄55-85岁，平均年龄（68.6±10.2）岁。回顾性分析所有患者的病变位置、入路、操作手法、介入技术及治疗结果等相关资料。结果15例患者共20处闭塞病变行介入血管成型术，双侧股动脉联合入路8例，单侧肱动脉＋单侧股动脉2例，单侧肱动脉＋双侧股动脉5例。19处闭塞病变完全开通，1例闭塞病变内径恢复80%（因扩张疼痛，支架未能完全扩张），开通成功率100%。并且无严重并发症发生。结论多入路联合介入治疗复杂主-髂动脉硬化性闭塞症是安全、有效的，可以增加介入治疗成功率；合理的入路选择、多种操作技术的综合应用可以扩展主-髂动脉硬化性闭塞症的介入治疗范围。

Objective To discuss the application of multi-approach combining interventional therapy for treating complex aorta-iliac arteriosclerotic occlusion. Methods The patients were chosen （n=15, including male 12 and female 3） aged from 55 to 85 and average age was （68.6±10.2） from Jun. 2011 to Jun. 2013. The relative data of lesion locations, approaches, operating manipulations, intervention techniques and treatment results were retrospectively analyzed in all patients. Results There were 20 occlusions in 15 patients received interventional angioplasty, including 8 with bilateral femoral combined approaches, 2 with unilateral brachial artery-unilateral femoral combined approaches, and 5 with unilateral brachial-bilateral femoral combined approaches. The occlusion was fully opened in 19 cases and internal diameter was recovered by 80%in 1 case （stent was not fully expanded due to expansive pain）. The success rate was 100%and there were no severe complications occurred. Conclusion Multi-approach combining interventional therapy for treating complex aorta-iliac arteriosclerotic occlusion is safe and effective, which can improve the success rate. The reasonable selection of approaches and comprehensive application of multi-operating technique can expand the therapeutic scale of international therapy in treatment of aorta-iliac arteriosclerotic occlusion.