薄壁低慢性外张力支架治疗股腘动脉闭塞性疾病的疗效分析

Analysis of the therapeutic effect of thin-walled low-chronic outward force stent in the treatment of femoral popliteal artery occlusive disease

目的分析薄壁低慢性外张力(COF)支架治疗股腘动脉闭塞性疾病的临床疗效。方法回顾性分析2018年6月至2019年5月上海交通大学医学院附属仁济医院连续收治的76例下肢股腘动脉闭塞性疾病(76条肢体)患者的临床资料,均实施Pulsar-18支架(Biotronic,德国)植入术。分析患者治疗后的临床症状和支架通畅率。结果76例患者均成功植入支架,术后临床症状Rutherford分级明显降低,下肢踝肱指数(ABI)明显升高(P<0.05)。随访24个月,3、6、12、24个月股腘动脉支架Ⅰ期通畅率分别为97.0%(64/66)、95.4%(62/65)、82.8%(53/64)、79.4%(50/63);6、12、24个月股腘动脉支架Ⅱ期通畅率分别为100%(65/65)、95.3%(61/64)、90.5%(57/63)。复杂性股腘动脉闭塞症的支架通畅率更低。结论薄壁低COF支架治疗股腘动脉闭塞性疾病安全有效,可以获得2年内良好的临床结果和Ⅰ期、Ⅱ期支架通畅率。精心的血管准备和涂药球囊的应用,可以降低股腘动脉支架的再狭窄率。

Objective To analyze the clinical effect of thin-walled low-chronic outward force(COF)stent in the treatment of femoral popliteal artery occlusive disease.Methods Retrospective analysis was made on the clinical data of 76 consecutive patients with femoral popliteal artery occlusive disease(76 limbs)of lower extremities admitted to Renji Hospital affiliated to Shanghai Jiaotong University Medical College from June 2018 to May 2019,all of whom underwent Pulsar-18 stent(Biotronic,Germany)implantation.The clinical symptoms and stent patency rate were analyzed.Results All 76 patients were successfully implanted with stents,and the Rutherford grade of postoperative clinical symptoms was significantly decreased,while the ankle brachial index(ABI)was significantly increased(P<0.05).After 24 months of follow-up,the patency rates of femoral popliteal artery stents in phaseⅠat 3,6,12 and 24 months were 97.0%(64/66),95.4%(62/65),82.8%(53/64)and 79.4%(50/63),respectively.The patency rates of femoral popliteal artery stents in phaseⅡat 6,12 and 24 months were 100%(65/65),95.3%(61/64)and 90.5%(57/63),respectively.The stent patency rate was lower in complex femoral popliteal artery occlusion.Conclusions The thin-walled and low-COF stent has good clinical results and patency in treatment of femoral popliteal artery occlusive disease.Good vessel prepare and drug-coated balloon may lower the in-stent restenosis.