主-双髂动脉全闭塞的介入治疗

Endovascular treatment for aorto-bi-iliac artery total occlusive disease

目的探讨介入治疗主．双髂动脉全闭塞性病变的可行性、安全性及疗效。方法回顾性分析2012年1月至2013年12月北京协和医院和石家庄市第一医院采用介入治疗主一双髂动脉全闭塞性疾病35例患者的临床资料，评价其治疗的可行性、安全性及近中期疗效。结果本组35例，男33例，女2例，平均年龄（67±6）岁。手术成功率100％，共置入裸支架129枚，覆膜支架4枚。无围手术期死亡，术后下肢踝肱指数（ABI）0．86±0．18，较术前0．28±0．17明显改善（P〈0．001）。围手术期并发症2例，肱动脉血栓和髂动脉扩张后破裂各1例，发生率为5．7％。术后随访2～28个月，平均随访（16．5±2．3）个月，2例（5．7％）失访，3例（8．6％）术后发生支架内再闭塞行二次介入治疗。全组总体通畅率91％（30／33）。结论介入治疗对于主双髂全闭塞性病变成功率高、中期结果较为满意。

Objective To investigate the feasibility, safety and efficiency of endovascular treatment for patients with aorto-bilateral-iliac artery total occlusive disease. Methods A total of 35 patients with aorto-bi-iliac artery total occlusive disease treated with endovascular therapy in Peking Union Medical College Hospital and the First Hospital of Shijiazhuang between Jan 2012 and Dec 2013 were retrospectively analyzed. Results There were 33 males and 2 females, mean age （67 ：t：6） years treated during the study period. Technical success rate was 100%. 129 bare stents and 4 covered stents were implanted. There were no peri-operative death. Postoperative leg ankle brachial index （ABI） improved significantly （0. 86 vs. 0. 28, P 〈 0. 28 ）. Postoperative complications occurred in 2 patients （ 5.7% ）, including brachial artery thrombosis and rupture of external iliac artery post-dilation. The mean follow-up period was 16. 5 months （2 -28 months）. Two patients （5.7%） were lost to follow up. Re-intervention was performed in 3 patients （ 8. 6%） due to reocclusion of the stents. Primary patency was 91% （ 30/33 ） Conclusions Endovascular treatment is effective for aorto-bi-iliac artery total occlusive disease with low complications and acceptable mid-term patent rate.