SilverHawk斑块切除系统治疗膝下动脉硬化闭塞

SilverHawk atherectomy in treatment of atherosclerotic occlusion of infrapopliteal artery

目的探讨SilverHawk斑块切除系统治疗膝下动脉硬化闭塞的临床效果。方法采用SilverHawk斑块切除系统治疗34例(39条患肢)膝下动脉硬化闭塞患者,观察治疗效果及随访结果。结果患者围手术期无死亡。39条患肢中,31条(28例患者)顺行开通成功,8条(6例)逆行开通成功,治疗成功率100%(39/39),技术成功率92.31%(36/39)。术后1周患者跛行距离、趾肱指数(TBI)及踝肱指数(ABI)均高于术前(P均<0.05)。术后随访2～46个月,平均(23.63±9.71)个月,溃疡愈合率90.00%(9/10);4条坏疽患肢中,1条膝下截肢。术后6、12、24个月患肢一期通畅率分别为87.18%(34/39)、82.05%(32/39)及71.79%(28/39),二期通畅率分别为94.87%(37/39)、92.31%(36/39)和84.62%(33/39)。结论采用SilverHawk斑块切除系统治疗膝下动脉硬化闭塞效果良好。

Objective To explore the therapeutic effect of SilverHawk atherectomy in the treatment of atherosclerotic occlusion of infrapopliteal arteries.Methods SilverHawk atherectomy was used to treat 34 patients(39 limbs)with atherosclerotic occlusion of infrapopliteal arteries.Then the therapeutic results and follow-up results were observed.Results There was no death during the perioperative period of SilverHawk atherectomy.Totally 31 limbs(28 cases)were treated antegradely,while 8 limbs(6 cases)were punctured retrogradely.The procedural success rate was 100%(39/39),and the technical success rate was 92.31%(36/39).One week after atherectomy,the claudication distance,toe brachial index(TBI)and ankle brachial index(ABI)were all higher than those before atherectomy(all P<0.05).All patients were followed up for 2 to 46 months(mean[23.63±9.71]months),the ulcer healing rate was 90.00%(9/10),and 1 of 4 gangrenous limbs underwent amputation below the knee.The primary patency rate at 6,12,24 months was 87.18%(34/39),82.05%(32/39)and 71.79%(28/39),respectively,while the secondary patency rate was 94.87%(37/39),92.31%(36/39)and 84.62%(33/39),respectively.Conclusion SilverHawk atherectomy is effective in treatment of atherosclerotic occlusion of infrapopliteal artery.