Silverhawk斑块旋切系统联合药物涂层球囊治疗下肢动脉硬化闭塞症的效果观察

Effect of Silverhawk atherectomy system combined with drug-coated balloon on patients with arteriosclerosis obliterans of lower extremities

目的观察下肢动脉硬化闭塞症(ASO)患者经Silverhawk斑块旋切系统联合药物涂层球囊(DCB)治疗的临床效果,探讨未来ASO治疗方案的优化。方法抽取2018年1月至2019年6月郑州人民医院及郑州大学第五附属医院接受治疗的ASO患者142例,采用数字奇偶法将纳入患者分为观察组(偶数)和对照组(奇数),每组71例。对照组接受常规治疗联合DCB治疗,观察组在对照组基础上联合Silverhawk斑块旋切系统治疗。分别于治疗前、治疗后6个月、治疗后12个月,检测两组患者患肢踝肱指数(ABI)、最小管腔直径(MLD),并进行比较。记录并比较两组治疗后12个月的Rutherford分级情况。记录并比较两组患者晚期腔管丢失及靶血管一期通畅情况。结果治疗后6个月时,两组ABI、MLD均较治疗前升高,治疗后12个月时回降,且观察组治疗后6、12个月的ABI、MLD均高于对照组(P均<0.05)。治疗后12个月,观察组Rutherford分级优于对照组(P<0.05),观察组晚期腔管丢失小于对照组,且靶血管一期通畅率高于对照组(P<0.05)。结论ASO患者经Silverhawk斑块旋切系统联合DCB治疗效果显著,更利于改善患者踝肱部动脉压、扩张MLD、提高血管一期畅通率。

Objective To observe the therapeutic effects of the Silverhawk atherectomy system combined with drug-coated balloon(DCB)on patients with arteriosclerosis obliterans of lower extremities(ASO),so as to guide the optimization of ASO treatment in the future.Methods A total of 142 ASO patients who were treated in Zhengzhou People’s Hospital and the Fifth Affiliated Hospital of Zhengzhou University from January 2018 to June 2019 were selected.And they were divided into observation group(even number)and control group(odd number)by digital parity method,with 71 cases in each.The control group received conventional treatment combined with DCB treatment,and the observation group was combined with Silverhawk atherectomy system based on the treatment of the control group.The ankle brachial index(ABI)and minimum lumen diameter(MLD)of the affected limbs of the two groups were tested and compared before treatment,after 6 months and 12 months of treatment.After 12 months of treatment,the Rutherford classification of the two groups was recorded and compared.The late lumen loss and primary patency of the target vessel in the two groups were recorded and compared.Results After 6 months of treatment,the ABI and MLD of the two groups were higher than those before treatment,and decreased after 12 months of treatment(P<0.05).The ABI and MLD of the observation group were higher than those of the control group after 6 months and 12 months of treatment,and the difference was statistically significant(P<0.05).After 12 months of treatment,the Rutherford classification of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).The late lumen loss of the observation group was smaller than that of the control group,and the primary patency rate of the target vessel was higher that of the control group,and the difference was statistically significant(P<0.05).Conclusions The treatment of ASO patients with the Silverhawk atherectomy system combined with a drug-coated balloon is more effective in improving the arterial pressure of the ankle and brachial area,dilating the minimum lumen diameter,and increasing the primary vascular patency rate.