腘动脉逆行穿刺治疗股腘动脉闭塞症

Retrograde transpopliteal access for femorai-popliteal artery occlusion by blind puncture

目的探讨盲穿法腘动脉逆向穿刺治疗股腘动脉闭塞的效果。方法对2014年9月—2016年6月收治的22例股腘动脉闭塞患者的临床资料进行回顾性分析。所有患者均采用盲穿法腘动脉逆向穿刺完成腔内治疗。结果所有病例均顺利完成手术。膝上腘动脉穿刺18例，膝下腘动脉穿刺4例。术后患者症状均获得改善，ABI较术前平均增加0.57，2例患者腘动脉穿刺点局部血肿，其他围手术期并发症包括肺部感染1例、肾功能不全2例。平均随访时间（13±5）个月，8例患者（36.4%）出现支架内再狭窄或闭塞，术后6个月的一期通畅率为（86.4±0.07）%，术后12个月的一期通畅率为（70.7±0.12）%，无大肢体截肢及死亡。结论盲穿法腘动脉逆向穿刺治疗股腘动脉闭塞安全、有效。

Objective To evaluate retrograde transpopliteal access for femoral-popliteal artery total occlusion with blind puncture. Methods Clinical data of 22 cases admitted from Sep 2014 to June 2016 undergoing endovascular treatment of the femoral-politeal artery occlusion with transpopliteal artery retrograde access by blind puncture were analyzed. Results A total of 22 patients underwent retrograde popliteal access with blind puncture after antegrade attempts failed. Puncture above the knee was performed in 18 cases and below the knee in 4 cases. The average increase of ABI was 0. 57. Hematoma of puncture site was observed in 2 patients, other complications included pneumonia in 1 case and renal insufficiency in 2 cases. The mean follow-up time was （13 ± 5 ）months. Restenosis occurred in 8 patiens （36. 4% ）during the follow- up time. The primary patency was （86. 4 ± 0.07 ） % at 6 months and （70. 7 ± 0. 12） % at 12 months. There was no major amputation rate and mortality during the follow-up. Conclusions Retrograde transpopliteal access for femoral-popliteal artery occlusion with blind puncture is safe and effective.