TurboHawk斑块切除系统联合药物涂层球囊在治疗股腘动脉硬化闭塞性疾病中的应用

Application of Turbo Hawk atherectomy device combined with drug-coated balloon in treatment of femoropopliteal occlusive diseases

目的:评价应用Turbo Hawk斑块切除系统联合药物涂层球囊(DCB)治疗股腘动脉硬化闭塞性疾病的安全性和有效性。方法:2016年4月—2017年10月,对17例股腘动脉硬化闭塞性疾病患者应用Turbo Hawk斑块切除系统联合DCB治疗。17例患者平均年龄(66.9±10.5)岁;其中男14例,女3例;股腘动脉狭窄病变13例,闭塞性病变4例;术前Rutherford分级2~5级;术前踝肱指数(ABI)为0.49±0.18。结果:17例患者的血管病变全部经腔内开通成功,其中1例股动脉穿孔患者行补救性覆膜支架植入术,另1例远端栓塞患者经股动脉切开球囊导管取栓后血流恢复通畅,技术成功率88.2%。术后ABI为0.99±0.27,明显高于术前(P=0.03)。术后3、6个月一期通畅率分别为94.1%,88.2%,二期通畅率100%。结论:Turbo Hawk斑块切除系统联合药物涂层球囊治疗股腘动脉硬化闭塞性疾病安全有效,早期效果满意。

Objective： To evaluate the safety and efficacy of using TurboHawk atherectomy device in combination with drugcoated balloon （DCB） in treatment offemoropopliteal occlusive diseases. Methods： During April 2016 to October 2017, the treatment of using TurboHawk atherectomy device in combination with DCB was performed in 17 patients with femoropopliteal occlusive diseases. Of the 17 patients, the average age was （66.9±10.5） years; 14 cases were male and 3 cases were female; 13 cases had femoropopliteal stenosis and 4 cases had femoropopliteal occlusion; the preoperative Rutherford classification ranged from 2 to 5 and the preoperative ankle brachial index （ABI） was 0.49＋0.18. Doppler ultrasound, CTA or MRA was used to evaluate the patency of target-lesion, postoperatively. Results： Endovascular recanalization of the target lesions were successfully performed in all the 17 patients, of whom, one case with femoral artery perforation underwent salvage covered-stent placement, and one case with distal embolization achieved vascular patency after balloon catheter embolectomy via incision of the femoral artery, and the technical success rate was 88.2%. The postoperative ABI was 0.99±0.27, and it was significantly higher than the preoperative value （P=0.03）. The primary patency rate at postoperative 3 and 6 months was 94.1% and 88.2% respectivel}5 and the secondary patency was 100%. Conclusion： Using TurboHawk atherectomy device in combination with DCB is safe and effective in treatment of femoropopliteal occlusive diseases, with favorable short-term results.