斑块切除联合药物涂层球囊治疗股腘动脉硬化闭塞症应用进展

Application progresses of atherectomy combined with drug-coated balloon for femoropopliteal artery disease

股腘动脉(FPA)是下肢动脉硬化闭塞症的好发部位。腔内治疗是治疗FPA硬化闭塞症的主要方式,然而术后再狭窄是目前面临的主要问题。与普通球囊血管成形术相比,药物涂层球囊(DCB)可明显提高管腔通畅率。良好的血管准备是充分发挥DCB预防再狭窄作用的前提,但在严重钙化、完全闭塞以及支架内再狭窄等复杂性FPA病变的治疗过程中,由于弹性回缩及限流性夹层等原因,DCB的应用受到限制。斑块切除技术虽不能提高血管的远期通畅率,但管腔即刻血流恢复良好,可为应用DCB创造条件。本文基于斑块切除系统和DCB的特点对二者联合治疗FPA硬化闭塞症的应用进展进行综述。

Femoropopliteal artery(FPA)is the most common site of peripheral arteriosclerosis obliterans.Endovascular therapy has become the main approach to treat FPA arteriosclerosis obliterans,but restenosis after operation is the main problem.Compared with traditional plain balloon angioplasty,drug-coated balloon(DCB)can significantly improve the primary patency rate.Proper vascular preparation is prerequisite,and DCB can fully exert the therapeutic effect of preventing restenosis.However,for complex FPA lesions such as severe calcification,total occlusion and in-stent restenosis,the application of DCB is still limited due to elastic recoil and flow-limiting dissection.Although atherectomy fails to improve the long-term vessel patency,it is likely to obtain optimal acute angiographic results in preparation for the application of DCB.Application progresses of atherectomy combined with DCB for FPA arteriosclerosis obliterans based on characteristics of plaque removal system and DCB were reviewed in this article.