切割球囊配合Chocolate球囊行复杂股腘动脉病变管腔准备的效果分析

Effect of cutting balloon combined with Chocolate balloon in vessel preparation of complex femoropopli-teal artery lesion

目的评估切割球囊配合Chocolate球囊行复杂股腘动脉病变药物涂层球囊扩张前管腔准备的效果。方法回顾性分析2020年8月至2022年5月采用切割球囊配合Chocolate球囊进行药物涂层球囊扩张前复杂股腘动脉病变管腔准备的患者共7例。记录术中病变平均长度,慢性完全闭塞病变情况,钙化程度PACSS分级,球囊扩张前后狭窄率及夹层形成等。随访患者靶血管通畅率及不良事件、再干预等情况。结果7例患者的病变平均长度为(197.71±73.79)mm,其中6例存在慢性完全闭塞病变,平均长度为(198.50±69.31)mm。PACSS分级:3级3例,4级4例。6例达到良好管腔准备,1例局限性C型夹层形成,行补救性支架植入,最终手术技术成功率为100%。7例患者均完成随访,平均随访(9.0±2.6)个月。随访期间均无主要不良肢体事件发生,无死亡及截肢。2例发生靶血管再狭窄,其中1例再干预成功再通靶血管。结论切割球囊配合Chocolate球囊行复杂股腘动脉病变药物涂层球囊扩张前管腔准备安全有效。

Objective To evaluate the effect of cutting balloon combined with Chocolate balloon on the vessel preparation of complex femoropopliteal artery lesion before drug coated balloon(DCB)dilation.Methods A retrospective analysis was conducted on 7 cases of vessel preparation of complex femoropopliteal lesion using cutting balloon combined with Chocolate balloon before DCB dilation from August 2020 to May 2022.Details including lesion length,chronic total occlusive(CTO)lesion,PACSS scoring system of calcification,stenosis rate before and after balloon dilation,and the formation of dissection during operation were observed.The major adverse limb events(MALE),target vessel patency rate and re-intervention rate were followed up.Results The average length of lesions was 197.71±73.79 mm in all 7 patients,of which 6 had CTO lesion with an average length of 198.50±69.31 mm.PACSS grading revealed that level 3 in 3 cases and level 4 in 4 cases.Good vessel preparation was achieved in 6 cases,and localized C-type dissection was found and performed bail-out stenting in 1 case.The success rate of surgical technique was 100%.All cases completed follow-up,with an average of 9.0±2.6 months.No MALE,death or amputation occurred during the follow-up period.Two cases experienced target vessel restenosis,and of which one case underwent re-intervention successfully.Conclusion The application of cutting balloon combined with Chocolate balloon is safe and effective for the vessel preparation of complex femoropopliteal artery lesion before DCB dilation.