Objective. To review our preliminary experience and evaluate our early results of a combined intraoperative iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive d...Objective. To review our preliminary experience and evaluate our early results of a combined intraoperative iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive disease. Methods. From July 1999 to April 2000, intraoperative iliac angioplasty and stenting combined with simultaneous femoro- popliteal bypass were performed on 12 lower extremities of 10 patients suffering from multilevel atherosclerotic occlusive disease. There were 8 men and 2 women, average 72 years. The indications for procedures included disabling claudication in 3 and rest pain in 7 patients. Results. Eleven iliac angioplasty and stent procedures combined with simultaneous 9 femoro- popliteal bypass and 3 femoro- femoral- popliteal bypass were performed in 12 limbs of 10 patients. Angioplasty and stent placement was technically successful in all patients. One contralateral femoral- popliteal bypass was failure after femorofemoral- popliteal bypass. There were no additional instances of procedural or postoperative morbidity or mortali- ty. Mean follow- up was 5 months (range 1～ 10 months). During the follow- up period, one femoro- infrapopliteal graft became occluded after 7 months and above- knee amputation was required. The cumulative primary patency rate of stented iliac arteries, femoro- femoral bypass grafts and femoro- popliteal bypass grafts were 100％ (11/11), 100％ (3/3) and 90.9％ (10/11) in the follow- up period, respectively. The amputation rate was 8.3％ (1/12). Conclusions. Intraoperative iliac artery PTA and stent placement can be safely and effectively performed simultaneously with infrainguinal revascularization for multilevel atherosclerotic occlusive disease by skilled vascular surgeon, using a portable C arm fluoroscopy in the operating room. Furthermore, iliac artery PTA and stenting was valuable adjunct to distal bypass either to improve inflow and outflow, or to reduce the extent of traditional surgical intervention, and also, any angioplasty and stenting- related complications can be immediately corrected as well.展开更多
Objective To examine long term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy Methods A total of 790 patients who underwent su...Objective To examine long term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy Methods A total of 790 patients who underwent successful PTCA and PTCA+stent in this hospital were followed by direct interview or letter The rate of follow up was 84 2% and the period of follow up was 0 9-12 7 (3 5±2 4) years Results During follow up, 4 (0 5%) patients died, 22 (2 8%) had nonfatal acute myocardial infarction, 10 (1 3%) had coronary artery bypass surgery, and 98 (12 4%) had repeat PTCA The rate of recurrent angina pectoris was 31 1% The cardiac event free survival rate calculated by the Kaplan Meier method was 88 2% at 1 year and 80 6% at 12 7 years Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events Compared to the PTCA group, patients with PTCA+stent had significantly lower rates of total cardiac events Conclusion The long term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA+stent therapy should be the major treatment for revascularization in patients with coronary heart disease展开更多
文摘Objective. To review our preliminary experience and evaluate our early results of a combined intraoperative iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive disease. Methods. From July 1999 to April 2000, intraoperative iliac angioplasty and stenting combined with simultaneous femoro- popliteal bypass were performed on 12 lower extremities of 10 patients suffering from multilevel atherosclerotic occlusive disease. There were 8 men and 2 women, average 72 years. The indications for procedures included disabling claudication in 3 and rest pain in 7 patients. Results. Eleven iliac angioplasty and stent procedures combined with simultaneous 9 femoro- popliteal bypass and 3 femoro- femoral- popliteal bypass were performed in 12 limbs of 10 patients. Angioplasty and stent placement was technically successful in all patients. One contralateral femoral- popliteal bypass was failure after femorofemoral- popliteal bypass. There were no additional instances of procedural or postoperative morbidity or mortali- ty. Mean follow- up was 5 months (range 1～ 10 months). During the follow- up period, one femoro- infrapopliteal graft became occluded after 7 months and above- knee amputation was required. The cumulative primary patency rate of stented iliac arteries, femoro- femoral bypass grafts and femoro- popliteal bypass grafts were 100％ (11/11), 100％ (3/3) and 90.9％ (10/11) in the follow- up period, respectively. The amputation rate was 8.3％ (1/12). Conclusions. Intraoperative iliac artery PTA and stent placement can be safely and effectively performed simultaneously with infrainguinal revascularization for multilevel atherosclerotic occlusive disease by skilled vascular surgeon, using a portable C arm fluoroscopy in the operating room. Furthermore, iliac artery PTA and stenting was valuable adjunct to distal bypass either to improve inflow and outflow, or to reduce the extent of traditional surgical intervention, and also, any angioplasty and stenting- related complications can be immediately corrected as well.
文摘Objective To examine long term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy Methods A total of 790 patients who underwent successful PTCA and PTCA+stent in this hospital were followed by direct interview or letter The rate of follow up was 84 2% and the period of follow up was 0 9-12 7 (3 5±2 4) years Results During follow up, 4 (0 5%) patients died, 22 (2 8%) had nonfatal acute myocardial infarction, 10 (1 3%) had coronary artery bypass surgery, and 98 (12 4%) had repeat PTCA The rate of recurrent angina pectoris was 31 1% The cardiac event free survival rate calculated by the Kaplan Meier method was 88 2% at 1 year and 80 6% at 12 7 years Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events Compared to the PTCA group, patients with PTCA+stent had significantly lower rates of total cardiac events Conclusion The long term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA+stent therapy should be the major treatment for revascularization in patients with coronary heart disease
