覆膜支架和裸支架在主髂动脉闭塞症腔内治疗中的循证与经验

Endovascular treatment of aortoiliac occlusive disease with covered and bare-metal stents:evidence and experience

支架植入已成为主髂动脉闭塞病变腔内治疗的常规性操作,而覆膜支架(CS)与裸支架(BMS)孰优孰劣尚无定论。本文以重建腹主动脉分叉与否,对已发表的对比性研究证据分节阐述,发现不同设计的研究得出的结果不尽相同。大宗病例的回顾性研究得出CS与BMS的中期结果相仿,而仅有的一项前瞻性随机对照研究凸显CS的优势。临床决策中,除了参考循证学的证据外,还需有多方面因素的考量,以保证手术的安全、有效和经济。

Stent implantation has become a routine procedure for the endovascular treatment of aortoiliac occlusive disease,while the superiority of covered stent(CS)or bare-metal stent(BMS)has not been concluded.In this paper,the published comparative studies were described in sections according to whether the abdominal aortic bifurcation was reconstructed.It was found that the results of different studies were not the same.Retrospective studies in large samples showed that CS and BMS had similar mid-term results,while the only prospective randomized controlled trial highlighted the advantages of CS.In clinical decision-making,many factors should be taken into consideration besides the evidence,ensuring that the procedure is safe,effective and economical.