Drug-coated balloon angioplasty for the treatment of intracranial arterial stenosis in a young stroke patient:A case report

BACKGROUND Intracranial arterial narrowing is a significant factor leading to brief episodes of reduced blood flow to the brain,known as transient ischemic attacks,or fullblown strokes.While atherosclerosis is commonly associated with intracranial arterial narrowing,it is frequently of a non-atherosclerotic nature in younger patients.CASE SUMMARY Here,we present the case of a young stroke patient with narrowing of the middle cerebral artery(MCA),characterized as non-atherosclerotic lesions,who experienced an ischemic stroke despite receiving standard drug therapy.The patient underwent digital subtraction angiography(DSA)to assess the entire network of blood vessels in the brain,revealing significant narrowing(approximately 80%)in the M1 segment of the right MCA.Subsequently,the patient underwent Drug-Coated Balloon Angioplasty to treat the stenosis in the right MCA's M1 segment.Follow-up DSA confirmed the resolution of stenosis in this segment.Although the remaining branches showed satisfactory blood flow,the vessel wall exhibited irregularities.A review of DSA conducted six months later showed no evident stenosis in the right MCA,with a smooth vessel wall.CONCLUSION The use of drug-coated balloon angioplasty demonstrated favorable outcomes in repairing and reshaping the blood vessel wall in young patients.Therefore,it may be considered a promising treatment option for similar cases.

The Efficacy and Safety of Drug-Coated Balloons in the Treatment of Acute Myocardial Infarction

The incidence of acute myocardial infarction (AMI) is increasing year by year, which seriously endangers human health around the world. The preferred treatment strategy for AMI patients is the use of drug-eluting stents (DES), as there is ample evidence to suggest that stent implantation can reduce major adverse cardiovascular events (MACEs). With the application of drug-coated balloons (DCBs) and the enhancement of the concept of interventional without implantation, the question is whether DCBs can be safely and effectively used in patients with AMI? The purpose of this study was to investigate the safety and effectiveness of DCBs in the treatment of AMI. A retrospective review of clinical data was conducted on 55 AMI patients who underwent primary percutaneous coronary intervention (PCI) from January 2020 to December 2021. Of these patients, 25 were treated with DCBs and 30 were treated with DESs. Optical coherence tomography (OCT) was used to measure the minimum lumen diameter, lumen stenosis, and coronary artery dissection before and after surgery, and angina pectoris attacks and various MACEs were recorded at 1, 6, and 12 months after surgery. The results showed that there were no significant differences in clinical baseline data between the two groups. However, the minimum lumen diameter of the DCB group immediately after the operation was smaller than that of the DES group, and the stenosis degree of the lumen in the DCB group was higher than that in the DES group. The incidence of coronary artery dissection in the DCB group was significantly higher than that in the DES group, but the majority of them were type B. At 1, 6, and 12 months after treatment, there was no significant difference in the occurrence of MACEs between the two groups. In conclusion, DCBs is a safe and effective treatment for AMI. However, the incidence of coronary artery dissection in DCB patients is higher than that in DES patients, but the majority of them are type B. .

A novel cerebrovascular drug-coated balloon catheter for treating symptomatic intracranial atherosclerotic stenosis lesions:Study protocol for a prospective,multicenter,single-arm,target-value clinical trial

Background:Previous single-center studies have demonstrated that drug-coated balloons(DCBs)may reduce restenosis rates,which is an important factor affecting the prognosis for intracranial interventional therapy.However,currently available cardiac DCBs are not always suitable for the treatment of intracranial atherosclerotic stenosis(ICAS).This study aimed to evaluate the safety and efficacy of a novel DCB catheter designed for patients with severely symptomatic ICAS.Methods:This prospective,multicenter,single-arm,target-value clinical trial was conducted in 9 Chinese stroke centers to evaluate the safety and efficacy of a novel DCB catheter for treating symptomatic severe ICAS.Primary metrics and other indicators were collected and analyzed using SAS version 9.4(SAS Institute,Cary,NC,USA).Results:A total of 155 patients were enrolled in this study.The preliminary collection of follow-up data has been completed,while data quality control is ongoing.Conclusion:Results of this study demonstrated the patency rate,safety,and effectiveness of a novel on-label paclitaxel DCB designed for the treatment of ICAS.Ethics and dissemination:This study,involving human participants,was reviewed and approved by the Ethics Committee of Drugs(Devices)Clinical Experiment at Henan Provincial People’s Hospital(reference number:2020-145-03)and other research centers participating in the clinical trial.The results of this study will be presented at international conferences and sent to peer-reviewed journals for publication.Standard protocol items:The Recommendations for Interventional Trials checklist was used when drafting the study protocol.Trial registration number:Registered with the Chinese Clinical Trial Registry on June 11,2021(Chi CTR2100047223).

Drug-coated balloons for treating de novo lesions in large coronary vessels:A case report

BACKGROUND Percutaneous transluminal coronary angioplasty,while an effective intervention,can frequently lead to acute occlusion with severe consequences.Although clinical trials have demonstrated the efficacy of drug-coated balloons(DCB)in treating acute coronary artery occlusion and in preventing restenosis,there has been limited exploration on the use of DCB in treating de novo lesions in large vessels.Currently,DCB are only recommended for patients with small vessel lesions and in-stent restenosis lesions,those at high risk of bleeding,and other special groups of patients.CASE SUMMARY This report presents a case of successful drug-coated balloon treatment of de novo lesions in large coronary vessels.Postoperatively,the patient demonstrated favorable recovery,with subsequent examination results revealing no significant differences from the previous examination.CONCLUSION The successful treatment of the patient in our case highlights the potential of DCB in the treatment of de novo lesions in large coronary vessels.

Application of drug-coated balloon in coronary artery intervention： challenges and opportunities

In recent decades, the outcomes of coronary heart disease （CHD） have markedly improved, which can be partly attributed to the use of novel drugs （especially statins and antiplatelet drugs） and partly to the evolution ofpercutaneous coronary intervention （PCI）. From percutaneous transluminal coronary angioplasty to bare-metal stent and then to drug-eluting stent, every step of PCI is attractive to interventional cardiologist, great progress has been made for patients with CHD. In the past few years, some successor devices for treating CHD have cmerged. Undoubtedly, drug-coated balloon （DCB）, which was recommended by 2014 ESC Guidelines on myocardial revascularization, is a ＂shining star＂ among them. DCB involves a semi-compliant angioplasty balloon coated with an anti-proliferative agent that can exert antirestenotic efficacy by permeating into the vessel wall during balloon contact. This review discusses the conception and merits, preclinical data, emerging clinical indications, and results from clinical trials of this novel interventional technology. Although DCB has shown authentic efficacy in the treatment ofin-stent restenosis, its use in de novo coronary lesions is still in dispute. Hence, concerns and the future direction of DCB are also covered in this paper.

Restenosis of a drug eluting stent on the previous bioresorbable vascular scaffold successfully treated with a drug-coated balloon: A case report

BACKGROUND The in-stent restenosis(ISR)rates are reportedly inconsistent despite the increased use of second-generation drug eluting stent(DES).Although bioresorbable vascular scaffold(BVS)have substantial advantages with respect to vascular restoration,the rate of scaffold thrombosis is higher with BVS than with DES.Optimal treatment strategies have not been established for DES-ISR to date.CASE SUMMARY We report on a case of a 60-year-old man patient with acute coronary syndrome.He had a history of ST-segment elevation myocardial infarction associated with very late scaffold thrombosis and treated with a DES.Coronary angiography revealed significant stenosis,suggesting DES-ISR on the previous BVS.Optical coherence tomography(OCT)identified a plaque rupture and a disrupted scaffold strut in the neointimal proliferation of DES.To treat the DES-ISR on the previous BVS,we opted for a drug-coated balloon(DCB)after a balloon angioplasty using a semi-compliant and non-compliant balloon.The patient did not experience adverse cardiovascular events on using a DCB following the use of intensive dual antiplatelet therapy and statin for 24 mo.CONCLUSION This case highlights the importance of OCT as an imaging modality for characterizing the mechanism of target lesion failure.The use of a DCB following the administration of optimal pharmacologic therapy may be an optimal strategy for the treatment and prevention of recurrent BVS thrombosis and DES-ISR.

A Case Summary of the Application of a Drug-eluting Stent Combined with a Drug-Coated Balloon in Left Main Coronary Artery Disease

Objective:To evaluate the clinical efficacy of a drug-eluting stent(DES)combined with a drug-coated balloon(DCB)in the treatment of left main coronary artery bifurcation lesions.Methods:A retrospective analysis was conducted on the clinical data of eight patients with left main coronary artery bifurcation lesions treated with a DES combined with a DCB who were admitted to our hospital from July 2016 to July 2017.These eight patients all underwent DES treatment for their left main coronary artery and left anterior descending coronary artery lesions,and DCB treatment at the ostium of the left circumflex artery;six of the patients underwent surgical procedures under the guidance of intravascular ultrasonography.Immediate postoperative angiography was used to evaluate the patency of the diseased vessels,and the restenosis rate at the 6-month follow-up after the operation and the incidence of serious clinical events within 6 months were assessed as well.Results:The use of a DES combined with a DCB in the treatment of left main coronary artery bifurcation lesions had a low restenosis rate(left main coronary artery(8.4±5.3)%,left anterior descending coronary artery(18.2±5.0)%,left circumflex artery(30.5±16.5)%).No serious clinical events occurred in any patients.Conclusion:A DES combined with a DCB is a safe and effective interventional treatment for left main artery coro-nary bifurcation lesions.

A simple practical balloon anchoring technique within the guide catheter for chronic total occlusion (CTO) of the coronary artery

Dear Editor： Chronic total occlusions （CTOs） of the coronary artery are commonly encountered complex lesionst11. Percutaneous coronary intervention （PCI） for CTO is technically challenging due to low procedural success ratesTM. Microcatheter is one of the important devices for treatment of CTOTM. It has been widely used attributed to the excellent crossability whenever angula- tion and tortuousity of the coronary artery is encoun- tered. In the process, the microcatheter has to be withdrawn from the guide wire after the wire is proved to locate in the true lumen.

Drug-coated balloon-only strategy for percutaneous coronary intervention of de novo left main coronary artery disease: the importance of proper lesion preparation

This retrospective single-center registry study included all consecutive patients who underwent percutaneous coronary intervention (PCI) for a de novo left main coronary artery lesion using drug coated-balloon (DCB)-only strategy between August 2011 and December 2018. To best of our knowledge, no previous studies of DCB-only strategy of treating de novo left main coronary artery disease, exist. The primary endpoint was major adverse cardiovascular events (MACEs) including cardiac death, non-fatal myocardial infarction, and target lesion revascularization (TLR). The cohort was divided into two groups depending on weather the lesion preparation was done according to the international consensus group guidelines. Sixty-six patients (mean age 75±8.6, 72% male), 52% of whom had acute coronary syndrome, underwent left main PCI with the DCB-only strategy. No procedural mortality and no acute closures of the treated left main occurred. At 12 months, MACE and TLR occurred in 24% and 6% of the whole cohort, respectively. If the lesion preparation was done according to the guidelines, the MACE and TLR rates were 21.2% and 1.9%. Left main PCI with the DCB only-strategy is safe leading to acceptable MACE and low TLR rates at one year, if the lesion preparation is done according to the guidelines.

冷刀内切开联合电切疗法与球囊扩张疗法治疗男性单纯性尿道狭窄的临床价值对比

目的:对比男性单纯性尿道狭窄患者治疗中球囊扩张术、联合冷刀内切及电切术的效果。方法:于2022年10月—2023年10月开展研究,对象选自临沂市中心医院86例罹患男性单纯性尿道狭窄患者,通过随机数字表将其划分两组,对照组43例,试验组43例。对照组实施冷刀内切开联合电切疗法,试验组实施球囊扩张疗法。比较两组围术期临床指标、手术成功率、复发率、术后并发症发生情况。结果:试验组手术出血量比对照组少,手术时间、术后置管天数、首次下床活动恢复天数、住院天数均比对照组短(P<0.05);两组手术成功率比较,试验组比对照组高(P=0.013);两组疾病复发率比较,试验组比对照组低(P=0.019)。结论:球囊扩张疗法治疗男性单纯性尿道狭窄的效果优于冷刀内切联合电切疗法,围术期临床指标更佳,手术成功率更高,复发率与并发症发生率更低。

Cut-off values of lesion and vessel quantitative flow ratio in de novo coronary lesion post-drug-coated balloon therapy predicting vessel restenosis at mid-term follow-up

Background:Drug-coated balloons(DCBs)have emerged as potential alternatives to drug-eluting stents in specific lesion subsets for de novo coronary lesions.Quantitative flow ratio(QFR)is a method based on the three-dimensional quantitative coronary angiography and contrast flow velocity during coronary angiography(CAG),obviating the need for an invasive fractional flow reserve procedural.This study aimed to assess the serial angiographic changes of de novo lesions post-DCB therapy and further explore the cut-off values of lesion and vessel QFR,which predict vessel restenosis(diameter stenosis[DS]≥50%)at mid-term follow-up.Methods:The data of patients who underwent DCB therapy between January 2014 and December 2019 from the multicenter hospital were retrospectively collected for QFR analysis.From their QFR performances,which were analyzed by CAG images at follow-up,we divided them into two groups:group A,showing target vessel DS≥50%,and group B,showing target vessel DS<50%.The median follow-up time was 287 days in group A and 227 days in group B.We compared the clinical characteristics,parameters during DCB therapy,and QFR performances,which were analyzed by CAG images between the two groups,in need to explore the cut-off value of lesion/vessel QFR which can predict vessel restenosis.Student's t test was used for the comparison of normally distributed continuous data,Mann-Whitney U test for the comparison of non-normally distributed continuous data,and receiver operating characteristic(ROC)curves for the evaluation of QFR performance which can predict vessel restenosis(DS≥50%)at mid-term follow-up using the area under the curve(AUC).Results:A total of 112 patients with 112 target vessels were enrolled in this study.Group A had 41 patients,while group B had 71.Vessel QFR and lesion QFR were lower in group A than in group B post-DCB therapy,and the cut-off values of lesion QFR and vessel QFR in the ROC analysis to predict target vessel DS≥50%post-DCB therapy were 0.905(AUC,0.741[95%confidence interval,CI:0.645,0.837];sensitivity,0.817;specificity,0.561;P<0.001)and 0.890(AUC,0.796[95%CI:0.709,0.882];sensitivity,0.746;specificity,0.780;P<0.001).Conclusions:The cut-off values of lesion QFR and vessel QFR can assist in predicting the angiographic changes post-DCB therapy.When lesion/vessel QFR values are<0.905/0.890 post-DCB therapy,a higher risk of vessel restenosis is potentially predicted at follow-up.

质朴与丰赡:《白气球》叙事的美学追求

《白气球》是一部以质朴性与丰赡性为美学追求的伊朗儿童电影,其叙事的质朴性主要表现在简约的叙事结构、平缓的叙事节奏、朴实的叙事风格等方面;意蕴的丰赡性主要表现在逼真的社会图景、深切的人文关怀、象征的意味深长等方面。由此,《白气球》呈现出朴素、宁静、自然、散淡的诗意之美。

Drug-coated balloons are not inferior to drug-coated stents in the treatment of acute myocardial infarction and shorten the duration of dual antiplatelet treatment

Background:Drug-coated balloons(DCBs)are an up-and-coming tactic in treating in-stent restenosis and coronary artery small vessel disease,but their efficacy in treating acute myocardial infarction needs to be further explored.Methods:A meta-analysis of 7 studies was conducted to make a comparison with the results of DCB and drug-eluting stent implantation after a median follow-up of 15 months.Results:A total of 922 patients were included in this analysis in total,including 375 patients in the DCB group and 547 patients in the stent group.A total of 962 vascular diseases were manifested in the 2 groups.After 6 to 24 months of follow-up,there was no statistically significant difference with respect to major adverse cardiovascular events(odds ratio[OR]:0.82;95%confidence interval[CI]:0.52–1.29;Z=0.85;P=0.39),cardiac death(OR:0.92;95%CI:0.39–2.12;Z=0.21;P=0.84),target lesion revascularization(OR:1.09;95%CI:0.53–2.25;Z=0.24;P=0.81),late lumen loss(MD:−0.05;95%CI:−0.15 to 0.06;Z=0.85;P=0.40),or dual antiplatelet therapy(DAPT)(OR:1.04;95%CI:0.53–2.05;Z=0.11;P=0.91)between the 2 groups.In the DCB group,persistent residual stenosis or C-F dissection occurrence necessitated that a total of 30 patients receive extra bailout implantations.The rate of bailout stenting was 11.8%(95%CI:7.1–16).Moreover,the DCB group had a shorter DAPT duration compared with the stent group.Conclusion:Drug-coated balloons with shorter DAPT durations may be as effective and safe as stent therapy in treating acute myocardial infarction.

应用切割球囊与普通球囊治疗分叉病变的安全有效性分析

目的:对比简单策略治疗分叉病变过程中,应用切割球囊或普通球囊预扩张及血管成形术的有效性及安全性,为分叉病变治疗策略提供依据。方法:入选2009年至2013年期间,我院心内科218例冠心病患者233个分叉病变,分叉病变分型均为Duke D或Duke F型,边支血管直径>2.0mm,有明显血流动力学意义,主支病变经切割球囊预处理(CB组)或普通球囊预扩张(PB组)后置入支架,分支病变仅行切割球囊(CB组)或普通球囊预扩张(PB组),观察手术成功率、边支受累情况、并发症及随访主要心血管不良事件(MACEs)情况。结果:218例患者233个分叉病变位于前降支/第一对角支占73.4%(171例),回旋支/钝缘支占12.0%(28例),右冠状动脉/后降支或左心室后支占14.6%(50例)。CB组患者122例,PB组患者96例,两组患者临床基线资料与分叉病变特点比较,差异无统计学意义。CB组与PB组主支血管PCI成功率相似(98.1%vs.100%,P>0.05),但CB组患者分支血管PTCA成功率较高(92.1%vs.78.3%,P<0.05)。CB组患者围手术期心肌梗死发生情况亦少于PB组患者(4.1%vs.12.5%,P<0.05)。术后随访12个月结果表明,MACEs发生比率CB组少于PB组患者(5.31%vs.14.0%,P<0.05)。结论:简单策略治疗分叉病变过程中,应用切割球囊行预扩张及血管成形术对比普通球囊安全、有效,其成功率高,并发症较少,是临床实践中治疗冠状动脉分叉病变安全、有效、可行的方法。

ERCP中SEST联合EPBD对比单纯EST对胆总管结石取石的临床分析

目的观察经内镜逆行性胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)术中改良的内镜括约肌切开术(small endoscopic sphincterotomy,SEST)联合内镜乳头气囊扩张术(endoscopic papillary balloon dilation,EPBD)对比单纯EST对胆总管结石(直径>10 mm)取石术后并发症及取石成功率的效果。方法将收集的72例胆总管结石患者按照随机数字表法分为单纯EST组(36例)和SEST联合EPBD组(36例)。比较两组取石成功率、术后3 h和24 h血淀粉酶水平、总住院天数及出血、穿孔、死亡以及术后1年胆总管结石复发率。结果 SEST联合EPBD组与单纯EST组比较,术后3 h、24 h血淀粉酶值差异有统计学意义(P<0.05);单纯EST组术后出血、穿孔、死亡率与SEST联含EPBD组比较,差异无统计学意义(P>0.05)。住院天数及术后均随访1年胆管结石复发率单纯EST组高于SEST联合EPBD组,差异有统计学意义(P<0.05)。结论 SEST联合EPBD相对于单纯EST取石成功率相当,术后并发症发生率降低,且更为安全经济,有望成为今后内镜下治疗胆总管结石的趋势。

经皮冠状动脉介入术中双导丝球囊与普通球囊预扩张分支血管治疗冠状动脉分叉病变的安全性和有效性对比分析

目的 对比冠状动脉介入简单策略治疗冠状动脉分叉病变过程中,应用双导丝球囊与普通球囊预扩张分支血管的有效性及安全性,为分叉病变治疗策略提供依据.方法 回顾性分析201 1年1月至2014年1月首都医科大学附属北京安贞医院心内科经冠状动脉造影证实为冠状动脉分叉病变的患者162例,共170个分叉病变.按照分支血管处理措施分为双导丝球囊组（DB组,78例）和普通球囊组（PB组,84例）,分别给予双导丝球囊和普通球囊预扩张.观察2组患者手术成功率、分支受累情况、并发症及随访主要不良心脏事件（MACEs）发生情况.结果 2组患者临床基线资料与分叉病变受累情况及病变分型比较,差异均无统计学意义（P＞0.05）.2组患者主支血管经皮冠状动脉介入治疗成功率比较,差异无统计学意义（P＞0.05）,但DB组患者分支血管经皮冠状动脉血管成形术成功率高于PB组[94.0％（79/84）比81.4％ （70/86）],差异有统计学意义（P＜0.05）.DB组患者围术期心肌梗死发生率低于PB组[5.1％ （4/78）比17.9％ （15/84）],差异有统计学意义（P＜0.05）.术后随访12个月结果表明,DB组MACEs发生率低于PB组患者[6.7％（5/75）比15.0％ （12/80）],差异有统计学意义（P＜0.05）.结论 冠状动脉介入简单策略治疗冠状动脉分叉病变过程中,应用双导丝球囊行预扩张对比普通球囊安全、有效,成功率较高,并发症较少,是临床实践中治疗冠状动脉分叉病变安全、有效、可行的方法.

高水平消毒的简易呼吸球囊存储效期的研究

目的探讨简易呼吸球囊经高水平消毒后的存储效期,为消毒供应中心科学管理该类物品的存储效期及临床安全使用提供依据。方法将临床科室送至消毒供应中心的50套简易呼吸球囊采用高水平消毒,安装检测合格后使用经环氧乙烷灭菌的自封袋包装,送至临床科室(ICU、手术室等科室除外),统一存储于治疗室的抢救车内,于消毒后保存28天、2个月、3个月、4个月、5个月、6个月时分别采样,进行细菌学培养。结果不同储存效期的简易呼吸球囊的细菌培养均合格。结论经过高水平消毒后,存放于临床科室的简易呼吸球囊存储6个月是安全有效的。

克罗恩病在双腔气囊全小肠内镜下的表现

目的:观察克罗恩病(Crohn’s disease,CD)在双腔气囊小肠镜下的溃疡形态和发生部位,评价内镜下严重程度与临床表现严重程度的相关性,为医师根据内镜下表现诊断CD提供线索和依据。方法:前瞻性随访2015年7月至2016年12月中南大学湘雅三医院首次行全小肠双腔气囊小肠镜并确诊CD的45例患者,由2名经验丰富的消化内科内镜医师观察小肠镜下溃疡的形态,并进行简化CD内镜评分(simple endoscopic score for CD,SES-CD),分析SES-CD与CD活动指数(Crohn’s disease activity index,CDAI)的相关性。结果:在45名克罗恩病患者中,24例(53.33%)溃疡位于回肠末端,5例(11.11%)位于回结肠,16例(35.56%)位于上消化道未累及回肠末端,其中8例(17.78%)仅累及空肠。在CD患者中纵行溃疡有32例(71.11%)。SES-CD与CDAI评分无相关性(r=0.237,P=0.136)。结论:双腔气囊小肠镜下CD溃疡表现具有多样性且可仅累及上消化道或空肠,因此不能以回肠末端及回盲瓣完好而排除CD。CDAI评分不能完全评估CD的预后。

Impact of number of run-off vessels on interwoven nitinol mesh stents patency in the femoropopliteal segment

Objective To evaluate the impact of run-off vessels number on the outcomes of Supera stent(Abbott Vascular,Santa Clara,Calif,USA)for treatment of femoropopliteal occlusive disease.Methods We retrospectively evaluated the medical records of 188 consecutive patients(mean age 68.2±9.6 years,100 males)undergone angiography and woven mesh stent implantation in femoral or popliteal arteries or both arterial segments,in our institution between January 12014 and January 12018.Target lesion revascularization and major adverse limb events at 12-month were evaluated comparing patients with 1-,2-or 3-run-off vessels in the foot.Results Interventional success was achieved in 100%.Stent implantation involved in the femoral site in 56 patients(30.3%),the femoropopliteal in 92 patients(48.9%)and the popliteal site in 40 patients(21.3%).A significant improvement of ankle-brachial index(0.29±0.6 vs.0.88±0.3,P<0.001)and Rutherford class(5.3±0.8 vs.0.7±1.9,P<0.01)were observed before discharge.The median follow-up duration was 12.3 months(inter quartile range:11.0 to 13.9).During the follow-up period,52 patients(27.6%)had clinical events.Primary patency at 12 months was 72.4%.The primary patency significantly increased when the runoff status.Comparing the number of events among patients with different number of run-off vessels,a significant difference(P<0.001)was observed for patients having one(24.0%)and two run-off vessels(15.0%).Conclusions The outcomes of Supera stent in femoropopliteal occlusive disease depend strictly on the number of run-off vessels.

经皮腔内血管成形术联合支架置入治疗移植肾动脉狭窄的临床分析

目的探讨经皮腔内血管成形术(PTA)联合支架置入治疗肾移植术后移植肾动脉狭窄(TRAS的临床疗效。方法回顾性分析21例肾移植术后TRAS行PTA联合支架置入治疗患者的临床资料。总结肾移植受者中TRAS的发生情况,比较TRAS患者介入治疗前后相关指标变化情况,分析TRAS患者的预后情况。结果507例肾移植受者中有21例发生TRAS,发生率为4.1%(21/507)。TRAS诊断时间为术后5(4,7)个月,67%(14/21)在术后6个月内出现TRAS。与介入治疗前比较,介入治疗后1周和1个月TRAS患者血清肌酐、收缩压、舒张压以及移植肾动脉峰值血流流速均降低,估算肾小球滤过率(eGFR)、叶间动脉阻力指数均升高,差异均有统计学意义(均为P<0.05)。PTA联合支架置入术后随访期间,共有1例出现移植肾动脉再发狭窄,经单纯球囊扩张后好转,1例右股动脉穿刺点假性动脉瘤形成,1例移植肾动脉闭锁导致肾脏萎缩失功,其余18例术后均恢复良好。结论PTA联合支架置入是肾移植术后TRAS首选治疗方式,可明显改善移植肾功能,显著延长移植肾的生存时间。