不同钙化分型对TASCⅡA、B级股腘动脉硬化闭塞症腔内治疗的影响

Effect of different calcification types on intracavitary treatment of TASC Ⅱ A and B grade femoral popliteal arteriosclerosis obliterans

目的本研究旨在评估钙化对TurboHawk联合药物涂层球囊(drug-coated balloon,DCB)和单纯DCB两种手术方式在治疗股腘动脉硬化闭塞症TASC II A、B级中短期临床疗效的影响。方法回顾性分析2017年6月至2018年10月采用腔内治疗的82例股腘动脉硬化闭塞症患者的临床资料,A组(42例)行TurboHawk联合DCB治疗,B组(40例)行DCB治疗,术后对比两组的中短期临床效果。结果 82例患者手术均获成功,无死亡或截肢患者。A组与B组相比,在伴有轻度钙化时,两组患者术前、术后即刻及术后3、6、12个月的最小管腔直径(MLD)、晚期管腔丢失率(LLL)、靶血管12个月一期通畅率差异无统计学意义(P> 0.05);在伴有中、重度钙化时,靶血管12个月一期通畅率A组较B组明显提高,A组12个月MLD高于B组,LLL低于B组(均P <0.05)。结论在股腘动脉硬化闭塞症TASC II A、B级伴有轻度钙化的病变中推荐使用单纯DCB治疗;在伴有中、重度钙化的病变中TurboHawk联合DCB治疗优势明显,具有较好的中短期疗效。

ObjectiveThe purpose of this study was to evaluate the effect of calcification on the short-term clinical efficacy of Turbo Hawk combined with DCB vs DCB alone in the treatment of femoral popliteal arteriosclerosis obliterans(TASCⅡ A and B).MethodsThe clinical data of 82 patients with femoral popliteal arteriosclerosis occlusive disease receiving intracavitary treatment from June 2017 to October 2018 were retrospectively analyzed. Group A(n = 42)were treated with TurboHawk combined with DCB,and group B(n = 40)were treated with DCB alone.Results All surgeries were performed successfully. Compared with group B,the primary patency rate of target blood vessels at 12 months with mild calcification in group A showed no significant difference in MLD and LLL before,immediately after surgery and at 3,6 and 12 months after surgery(P > 0.05). With moderate and severe calcification,the 12-month primary patency rate of target vessels in group A was significantly higher than that in group B,the 12-month MLD in group A was higher than that in group B,and the LLL was lower than thatin group B(all P < 0.05).Conclusions DCB alone was recommendedin TASCⅡ A and B with mild calcificationin femoral popliteal arteriosclerosis obliterans,and TurboHawk combined with DCB has obvious advantages in lesions with moderate and severe calcification,and has good short-term and medium-term efficacy.