下肢动脉支架内再狭窄的诊断和治疗

Diagnosis and treatment of in-stent restenosis of lower extremity artery

随着人口老龄化的加重,下肢动脉狭窄与闭塞性疾病的发生率越来越高,同时伴随着腔内支架的广泛应用,支架内再狭窄的发生率也逐渐升高。目前治疗支架内再狭窄的技术主要有药物治疗、普通球囊、药涂球囊、金属裸支架、药物洗脱支架、腔内减容(激光、旋切)和旁路搭桥术等。单一治疗方法效果均有限,而腔内减容与药涂球囊联合既可以机械去除增生的内膜,又可以有效抑制内膜再增生,是目前治疗支架内再狭窄较为合理的方法。

With the aging of the population,the incidence of lower extremity arterial stenosis and occlusive disease is getting higher and higher,and the endovascular stents have been widely used,thus the incidence of in-stent restenosis is also increasing.At present,the techniques used for the treatment of ISR include drug therapy,plain balloon,drug-coated balloon,bare-metal stent,drug-eluting stent,intracavity volume reduction(laser atherectomy,excisional atherectomy)and bypass surgery.The effects of single treatment methods are limited,and intracavitary volume reduction combined with drug-coated balloon can mechanically remove the proliferating intima and effectively inhibit the intimal hyperplasia,which is a reasonable method for the treatment of in-stent restenosis.