激光消蚀联合球囊扩张治疗血栓闭塞性脉管炎导致的重度肢体缺血

Laser ablation combined with balloon angioplasty for critical limb ischemia due to thromboangiitis obliterans

目的观察激光消蚀联合球囊扩张治疗血栓闭塞性脉管炎导致的重度肢体缺血的疗效。方法收集2021年8月至11月于首都医科大学宣武医院接受激光联合球囊扩张治疗的8例脉管炎患者的临床资料,观察围手术期并发症及术后3个月、6个月的保肢率、疼痛评分、Rutherford分级和血管通畅情况。结果8例患者手术均成功,无围手术期并发症,6个月保肢率100%。4例患者破溃伤口均于3个月内愈合。1例足趾破溃坏疽患者术后4个月靶血管出现再闭塞,伤口已愈合,出现静息痛,接受肝细胞生长因子转移酶裸质粒注射治疗。患者术后疼痛评分较术前改善明显。结论激光消蚀联合球囊扩张治疗血栓闭塞性脉管炎导致的重度肢体缺血是安全有效的。

Objective To investigate the efficacy of laser ablation combined with balloon angioplasty in the treatment of critical limb ischemia due to thromboangiitis obliterans(TAO).Methods The clinical data of 8 patients with TAO,who were treated with laser ablation combined with balloon angioplasty at the Xuanwu Hospital of Capital Medical University of China between August and November of 2021,were collected.The complications during perioperative period,the postoperative 3-month,6-month limb retention rate,pain score,Rutherford grade,and vascular patency were recorded.Results Successful treatment was accomplished in all the 8 patients,and no perioperative complications occurred.The 6-month limb retention rate was 100%.In 4 patients the ulceration wound was healed within 3 months.Four months after treatment,one patient,who had toe ulceration and gangrene,developed re-occlusion of the target vessel,his wound was healed,but he developed resting pain and he had to receive naked plasmid injection of hepatocyte growth factor transferase.The postoperative pain scores were significantly improved when compared with the preoperative ones.Conclusion For the treatment of patients with critical limb ischemia due to TAO,laser ablation combined with balloon angioplasty is clinically safe and effective.