逆行支架植入治疗锁骨下动脉闭塞的初步评价

Preliminary assessment of retrograde endovascular stenting for subclavian artery occlusion

目的 总结逆行锁骨下动脉支架植入治疗重度锁骨下动脉狭窄和闭塞的初步临床经验。方法 1999年 9月至 2 0 0 3年 7月采取经肱动脉逆行植入支架治疗锁骨下动脉重度狭窄和闭塞共 19例。术前诊断包括彩色多普勒超声检查和动脉造影确诊。手术方法是经患侧上肢肘部小切口解剖肱动脉 ,逆行造影和支架植入。结果 本组支架植入成功 18例 ,支架植入满意 ,无移位。失败 1例 ,因病变闭塞完全 ,导丝无法通过闭塞部位而转行手术治疗。治疗成功的 18例中随访 16例 ,随访时间 2～ 4 8个月 ,平均 2 4个月。失访 2例 ,随访率 88 9%。有 2例分别于术后 11个月和 14个月出现再狭窄 ,1例再次行球囊扩张成功 ,1例转行手术治疗。结论 逆行锁骨下动脉支架植入是治疗锁骨下动脉重度狭窄和闭塞安全有效的方法。

Objective To investigate the preliminary clinical results of retrograde endovascular stenting for subclavian artery severe stenosis or occlusion. Methods From September 1999 to July 2003, retrograde endovascular balloon angioplasty and stent placement were performed on 19 patients suffering from severe stenosis or occlusion of subclavian artery.The retrograde endoluminal stenting procedure were performed through the brachial artery. ResultsThe procedures were technically successful in 18 of 19 patients.One case was failed and changed to bypass surgery.16 of 18 patients were followed up. The mean follow-up was 24 months (range 2-48months). During the follow-up period,2 cases developed restenosis after 11 months and 14 months, respectively. One was performed with PTA and one was treated by surgery. ConclusionRetrograde endovascular stenting for severe stenosis or occlusion of the subclavian arteries appears to be feasible and safe.