超声消融在治疗下肢动脉完全闭塞性病变中的应用

Application of ultrasonic angioplasty in treating totally occluded peripheral arteries, a clinical study of 39 cases

目的 评价超声消融治疗下肢动脉硬化性完全闭塞性病变的临床疗效和安全性。方法 对 39例下肢动脉硬化性完全闭塞患者 ,在数字减影动脉造影 (DSA)下采用经皮穿刺方法行血管腔内超声消融 (美国 ,ENHANCEDACOLYSIS ,ANGIOSONICS)治疗 ,观察血管再通、临床疗效和相关并发症情况。结果 经过平均 115 7s± 376s超声消融治疗后 ,管腔再通率 97.4 % (38/ 39) ,平均残余狭窄为 32 %± 11% ,技术成功率 (残余狭窄 <5 0 % )为 82 .1% (32 / 39)。 38例开通者临床症状有不同程度的改善。 2 4h、30d、90d和 180d的管腔通畅率分别为 10 0 % ,94 .7% ,89.5 %和 81.6 %。超声消融相关的并发症有血红蛋白尿 9例 ,远端栓塞 1例。结论 超声消融是治疗下肢动脉硬化性完全闭塞性病变的一种安全有效方法。

Objective To evaluate the efficacy and safety of intravascular ultrasonic angioplasty in treating atherosclerotic totally occluded peripheral arteries. Methods Percutaneous ultrasonic angioplasty was applied on 39 cases with peripheral atherosclerotic total occlusion under fluoroscopic guidance. The recanalization, clinical efficacy and complications were observed. Results 38(97.4%)of the 39 cases achieved successful recanalization in(1 157±376)seconds, with a mean residual stenosis of(32±11)%. The technical successful rate(residual stenosis <50%)was 82.1%(32/39).Clinical improvement at different degrees was seen in 38 cases after ultrasonic angioplasty. The patency rates 24 hours, 30 days, 90 days and 180 days after the ultrasonic angioplasty were 100%, 94.7%, 89.5% and 81.6% respectively. The complications related to ultrasonic angioplasty included hemoglobinuria in 9 cases and distal embolization in 1 case. Conclusion Ultrasonic angioplasty appears to be safe and effective for the treatment of atherosclerotic totally occluded peripheral arteries.