Rotarex在外周动脉疾病中的应用

Treatment strategy of peripheral arterial diseases with Rotarex

目的探讨Rotarex在外周动脉疾病(peripheral arterial disease,PAD)中的应用效果。方法回顾性分析2018年8月至2020年2月90例采用Rotarex治疗的PAD患者的临床及随访资料。结果90例患者中,下肢动脉粥样硬化性闭塞症合并急性血栓形成(arteriosclerosis obliterans complicated with acute thrombosis,ASOCAT)45例,移植物狭窄/闭塞27例,原发性/栓塞继发血栓形成16例,外伤性/医源性动脉闭塞2例。2例行复合手术,余88例行腔内手术。围手术期死亡2例,术后12个月内死亡2例,膝上截肢4例,血管再闭塞10例,失访5例。术后12个月踝肱指数(ABI)较术前显著增加(0.80±0.22比0.43±0.16,P<0.01)。12个月无再狭窄/闭塞率为82.7%,12个月无截肢生存率(major amputation-free survival,MAFS)为91.6%。结论对于不同类型PAD患者,采用Rotarex清除血管内负荷,配合球囊、支架等手段纠正残余病变,可以获得比较理想的疗效。

Objective To evaluate the effect of Rotarex in peripheral arterial disease(PAD).Methods The clinical data of 90 PAD patients treated with Rotarex from Aug 2018 to Feb 2020 were retrospectively analyzed.Results Among the 90 patients,45 patients had atherosclerotic obliterans complicated with acute thrombosis(ASOCAT),27 patients had graft restenosis or reocclusion,16 patients had primary or embolism-induced thrombosis,2 patients had traumatic or iatrogenic arterial occlusion.Except for 2 patients undergoing hybrid surgery,88 patients underwent endovascular treatment.Two patients died perioperatively.Within 12 months follow-up,2 patients died,4 patients underwent major amputation,target arteries of 10 patients were re-stenosed or re-occluded and 5 patients were lost to follow-up.Compared with the preoperative ankle-branchial index(ABI),significant increase was observed in the 12-month ABI(0.80±0.22 vs.0.43±0.16,P<0.01).The 12-month restenosis/re-occlusion-free rate was 82.7%,and the 12-month major amputation-free survival(MAFS)was 91.6%.Conclusion For PAD patients,acceptable outcomes can be achieved with reasonable use of Rotarex for debulking,combined with balloon,stent and other techniques to correct the residual lesions.