药物涂层球囊治疗下肢动脉长段病变的临床疗效观察

Clinical observation of drug-coated balloon in the treatment of lower extremity arterial long segment lesions

目的观察药物涂层球囊(DCB)治疗下肢动脉长段狭窄闭塞性病变的中期疗效。方法回顾性分析2017年2月至2018年1月中国医科大学附属第一医院血管外科收治的下肢动脉粥样硬化症患者80例(病变长度>10 cm),接受DCB治疗及支架置入治疗(BMS),比较两组患者术前、术后靶病变的一期通畅率、踝肱指数(ABI)、卢瑟福血管外科分级(Rutherford)、截肢率及临床症状和生活质量的变化。结果DCB组60例、BMS组20例,80例患者手术均获得技术成功。DCB组术后6、12个月的通畅率为83.33%、75.00%,BMS组为85.00%、65.00%。两组患者术后ABI与术前相比明显提高,行走距离较术前增加,Rutherford分级以及临床症状较术前改善。手术中DCB组1例出现限流性夹层、1例预扩后狭窄程度仍>50%,后行支架置入补救术。结论DCB治疗下肢动脉长段狭窄闭塞性病变可以获得较好的近、中期临床疗效。

Objective To observe the efficacy of drug -coated balloon (DCB) in the treatment of long -segment arterial stenosis in lower extremity. Methods Were retrospectively analyzed in February 2017 to January 2018,the First Hospital Affiliated to China Medical University of vascular surgical treated 80 patients with lower limb sclerosis of arterial congee appearance (lesion length>10 cm), accept the DCB and stents (BMS) treatment, compared two groups of patients with preoperative and postoperative issue patency rate of target lesion, ABI, Rutherford, amputation rate and the change of clinical symptoms and quality of life. Results There were 60 cases in DCB group,20 cases in BMS group and 80 cases in BMS group. The patency rate of DCB group was 83.33% and 75.00% at 6 and 12 months after operation. The patency rate was 85.00% and 65.00% in the BMS group at 6 and 12 months after surgery. ABI, walking distance, Rutherford grade and clinical symptoms were significantly improved in the two groups compared with those before surgery. During the operation, 1 patient in the DCB group presented flow limiting interlayer and 1 patient still had>50% stenosis after predilation, and then underwent stent implantation for remediation. Conclusion The treatment of lower limb arterial stenosis with DCB can obtain better near -and medium-term clinical efficacy.