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COMBINED INTRAOPERATIVE ILIAC ARTERY STENTS AND FEMORO- POPLITEAL BYPASS FOR MULTILEVEL ATHEROSCLEROTIC OCCLUSIVE DISEASE
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作者 刘昌伟 管珩 +2 位作者 李拥军 郑曰宏 刘卫 《Chinese Medical Sciences Journal》 CAS CSCD 2001年第3期165-168,共4页
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
关键词 atherosclerotic occlusive disease iliac angioplasty stentING femoro- popliteal bypass
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Prolonged high-pressure balloon angioplasty of femoropopliteal lesions:Impact on stent implantation rate and mid-term outcome 被引量:2
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作者 Gianluca Rigatelli Mariano Palena +4 位作者 Paolo Cardaioli Fabio dell'Avvocata Massimo Giordan Dobrin Vassilev Marco Manzi 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2014年第2期126-130,共5页
Objectives To assess the impact on stent implantation rate and mid-term outcomes of prolonged high pressure angioplasty of femoropopliteal lesions. Methods We retrospectively enrolled 620 consecutive patients from Jan... Objectives To assess the impact on stent implantation rate and mid-term outcomes of prolonged high pressure angioplasty of femoropopliteal lesions. Methods We retrospectively enrolled 620 consecutive patients from January 2011 to December 2011 (75.6 ±12.3 years, 355 males, 76.5%in Rutherford class 5-6), referred for critical limb ischemia and submitted to prolonged high-pressure angioplasty of femoropopliteal lesions. The definition of prolonged high-pressure angioplasty includes dilation to at least 18 atm for at least 120 s. Proce-dural data, and clinical and instrumental follow-up were analyzed to assess stent implantation rate and mid-term outcomes. Results The preferred approach was ipsilateral femoral antegrade in 433/620 patients (69.7%) and contralateral cross-over in 164/620 (26.4%) and pop-liteal retrograde+femoral antegrade in 23/620 (3.7%). Techniques included subintimal angioplasty in 427/620 patients (68.8%) and endolu-minal angioplasty in 193/620 patients (31.2%). The prolonged high pressure balloon angioplasty procedure was successful in 86.2%(minor intra-procedural complications rate 15.7%), stent implantation was performed in 74 patients (11.9%), with a significant improvement of ankle-brachial index (0.29 ±0.6 vs. 0.88 ±0.3, P〈0.01) and Rutherford class (5.3 ±0.8 vs. 0.7 ±1.9, P〈0.01), a primary patency rate of 86.7%, restenosis of 18.6%on Doppler ultrasound and a target lesion revascularization of 14.8%at a mean follow-up of 18.1 ±6.4 months (range 1-24 months). Secondary patency rate was 87.7%. Conclusions Prolonged high pressure angioplasty of femoropopliteal lesions appears to be safe and effective allowing for an acceptable patency and restenosis rates on mid-term. 展开更多
关键词 Peripheral artery disease angioplasty BALLOON stent
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Revisiting endovascular treatment in below-the-knee disease. Are drug-eluting stents the best option? 被引量:1
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作者 Stavros Spiliopoulos Panagiotis M Kitrou Elias N Brountzos 《World Journal of Cardiology》 CAS 2018年第11期196-200,共5页
Patients with below-the-knee arterial disease are primarily individuals suffering from critical limb ischemia(CLI), while a large percentage of these patients are also suffering from diabetes or chronic renal failure ... Patients with below-the-knee arterial disease are primarily individuals suffering from critical limb ischemia(CLI), while a large percentage of these patients are also suffering from diabetes or chronic renal failure or both. Available data from randomized controlled trials and their meta-analysis demonstrated that the use of infrapopliteal drug-eluting stents(DES), in short-to medium-length lesions, obtains significantly better results compared to plain balloon angioplasty and bare metal stenting with regards to vascular restenosis, target lesion revascularization, wound healing and amputations. Nonetheless, the use of this technology in every-day clinical practice remains limited mainly due to concerns regarding the deployment of a permanent metallic scaffold and the possibility of valid future therapeutic perspectives. However, in the majority of the cases, these concerns are not scientifically justified. Large-scale, multicenter randomized controlled trials, investigating a significantly larger number of patients than those already published, would provide more solid evidence and consolidate the use of infrapopliteal DES in CLI patients. Moreover, there is still little evidence on whether this technology can be as effective for longer below-the-knee lesions, where a considerable number of DES is required. The development and investigation of new, longer balloon-expanding or perhaps selfexpanding DES could be the answer to this problem. 展开更多
关键词 Critical limb ischemia Infrapopliteal arterial disease Drug-eluting stents Peripheral arterial disease Balloon angioplasty
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Long-term effect of stenting in unprotected left main coronary artery disease in the elderly 被引量:1
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作者 Caiyi LU Shiwen WANG +8 位作者 Lingling LIU Qiao XUE Xinli WU Taohong HU Pingshuan DONG Zhiping WANG Shenfang TIAN Pinfa LIU Jicai ZANG 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2005年第4期218-222,共5页
Objective To evaluate the feasibility,safety and efficacy of percutaneous stent implantation for treating left main coronary artery(LMCA)stenosis.Methods Consecutive patients with unprotected left main coronary artery... Objective To evaluate the feasibility,safety and efficacy of percutaneous stent implantation for treating left main coronary artery(LMCA)stenosis.Methods Consecutive patients with unprotected left main coronary artery disease treated by stent-based percutaneous intervention(PCI)at 6 medical centers in China were enrolled.Procedural data and clinical outcomes were obtained from all patients.Results From January 2001 to December 2004,138 patients(79 males and 59 females;mean age:69.7±5.8 years)underwent PCI for LMCA stenosis.Bare metal stents(BMS)were implanted in 51 patients with non-bifurcational lesions and in 5 patients with bifurcational lesions from January of 2001 to June of 2003(BMS group);.Drug eluting stents(DES)were used unselectively to cover both bifurcational and non-bifurcational lesions in 86 patients from July of 2003 to December of 2004(DES group).Procedural success rate of the 138 cases was 98%(135/138).One patient(0.7%)with bifurcation lesion who was treated with DES died from severe heart failure 2 weeks after the procedure.During a mean follow up period of 21.3±5.6 months,one patient died from renal failure,one from sudden cardiac death,4 underwent target lesion revascularization(TLR)in the BMS group,which all occurred in patients with bifurcational lesions;whereas in the DES group no deaths occurred and only one patient with bifurcational lesion had TLR.Conclusions(1)PCI is feasible and relatively safe to treat unprotected left main coronary artery disease in elderly patients at medical centers with experienced professionals.(2)BMS and DES have similar immediate and long-term efficacy in the treatment of ostium and shaft lesions of the LMCA.(3)DES are strongly suggested in the therapy of distal bifurcation lesion of unprotected LMCA. 展开更多
关键词 coronary artery disease interventional therapy angioplasty stent
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Clinical Outcomes in Patients Undergoing Triple-Vessel Angioplasty for Symptomatic Coronary Artery Disease
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作者 Ashraf Safiya Manzil Jithu Sam Rajan Venkatesh Radhakrishnan 《International Journal of Clinical Medicine》 2015年第10期746-752,共7页
Current treatment strategies for multi-vessel coronary artery disease include either coronary artery bypass surgery or percutaneous coronary intervention with stenting. The present study evaluates the morbidity and mo... Current treatment strategies for multi-vessel coronary artery disease include either coronary artery bypass surgery or percutaneous coronary intervention with stenting. The present study evaluates the morbidity and mortality among coronary artery disease patients undergoing triple-vessel angioplasty. This prospective record based descriptive study was carried out in Medical College, Pariyaram, Kannur, Kerala;a tertiary care cardiac centre in South India. Fifty consecutive patients who underwent angioplasty of one or more lesions in each of the three major coronary arteries from May 2010 to July 2012 were included in the study. The study describes the clinical profile of the patients and a moderate term clinical follow-up to reassess the symptoms, functional status and left ventricular function by history, electrocardiogram, echocardiogram, and treadmill test. Mortality and morbidity were considered as end-points of the study. Event-free survival rate was 94% at a mean follow-up of 20 months. Overall 98% continued success was obtained with triple-vessel angioplasty. Triple-vessel angioplasty is a safe and effective therapy as an alternative to surgical revascularization in selected patients with triple-vessel coronary artery disease. 展开更多
关键词 Coronary Artery disease REVASCULARIZATION stentS Triple-Vessel angioplasty
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CE-MRA在外周血管闭塞性疾病诊断中的应用 被引量:2
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作者 赵晶 刘明 +1 位作者 彭楠 郭红丽 《中国中西医结合影像学杂志》 2006年第3期170-173,共4页
目的:介绍对比增强磁共振血管成像(CE-MRA)在外周血管闭塞性疾病诊断中的方法及应用体会。方法:2005年2~7月间36例临床怀疑下肢动脉闭塞症患者行自动移床三维增强磁共振血管成像(3DCE-MRA)检查,范围包括主动脉、髂动脉、股动脉... 目的:介绍对比增强磁共振血管成像(CE-MRA)在外周血管闭塞性疾病诊断中的方法及应用体会。方法:2005年2~7月间36例临床怀疑下肢动脉闭塞症患者行自动移床三维增强磁共振血管成像(3DCE-MRA)检查,范围包括主动脉、髂动脉、股动脉、胭动脉及其三个分支。结果:36例中32例下肢动脉可见不同部位、不同程度的狭窄及闭塞。阳性诊断率89%。与数字减影血管造影(DSA)检查结果符合率94%。结论:正确掌握检查方法,可以获得良好的图像质量。自动移床3DCE-MRA是一种无创的、简便而有效的下肢血管性病变的检查方法。 展开更多
关键词 磁共振血管造影术 下肢 动脉闭塞病
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下肢动脉旁路术后随访:MRA的临床应用 被引量:1
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作者 王佩芬 周康荣 +4 位作者 陈祖望 杨军 沈继章 陈财忠 施惠斌 《临床放射学杂志》 CSCD 北大核心 1998年第3期156-158,共3页
目的:探讨MRA在下肢动脉旁路术后随访中的临床应用价值。材料与方法:20例下肢动脉旁路术后行2DTOFMRA检查,其中3例同时行动态增强MRA(DCEMRA)。20例中12例与彩超对照,4例与手术对照研究。结果:20... 目的:探讨MRA在下肢动脉旁路术后随访中的临床应用价值。材料与方法:20例下肢动脉旁路术后行2DTOFMRA检查,其中3例同时行动态增强MRA(DCEMRA)。20例中12例与彩超对照,4例与手术对照研究。结果:20例下肢动脉旁路术后随访MRA检查共显示移植血管19条,其中12例与彩超对照结果,两者示移植血管完全一致为11条,两者符合率为91.66%(11/12)。12条移植血管24个吻合口比较一致者21个,两者符合率87.5%(21/24)。结论:MRA可清晰显示移植血管和吻合口,是评价下肢动脉旁路术后疗效及随访的最佳影像学方法之一。 展开更多
关键词 下肢动脉闭塞 下肢动脉旁路术 磁共振血管造影
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Tim技术CE-MRA在下肢动脉闭塞性病变中的影像研究
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作者 顾勇坚 郑建刚 +1 位作者 许建兴 庄雄 《系统医学》 2018年第22期111-113,共3页
目的分析下肢动脉闭塞性疾病采用Tim技术CE-MER诊断的临床应用价值。方法选择该院2015年1月—2018年1月收治的35例高度疑似下肢动脉闭塞性病变患者,所有患者均行3D CE-MRA结合TWIST技术检查,对比手术结果分析Tim线圈3D CE-MRA结合TWIST... 目的分析下肢动脉闭塞性疾病采用Tim技术CE-MER诊断的临床应用价值。方法选择该院2015年1月—2018年1月收治的35例高度疑似下肢动脉闭塞性病变患者,所有患者均行3D CE-MRA结合TWIST技术检查,对比手术结果分析Tim线圈3D CE-MRA结合TWIST技术诊断下影像学图像特征。结果经分析35例患者的3D CE-MRA,所有患者均可耐受检查且获得了较好的原始图像,图像质量的优良率为(35/35)100.00%。在35例中患者31例下肢动脉血管可见不同程度的狭窄或闭塞,共计173段血管,其中盆段82段,大腿段50段,小腿段41段, 4例正常。结论 Tim线圈3D CE-MRA结合TWIST技术扫描可较为准确诊断评估下肢动脉不同节段血管不同程度的狭窄或闭塞,是一种诊断下肢动脉狭窄的无创、可靠、实用的血管检查方法。 展开更多
关键词 TIM 3DCE-mra TWIST 下肢动脉闭塞性疾病 影像
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Clinico-Angiographic Profile and Prevalence of Restenosis in Patients Undergoing Percutaneous Transluminal Coronary Angioplasty to Left Main Coronary Artery: An Observational Cohort Study
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作者 Dolly Mathew C. G. Sajeev 《World Journal of Cardiovascular Diseases》 2017年第11期413-422,共10页
Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to asses... Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to assess the clinical profile, angiographic status, and prevalence of restenosis in patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in LMCA. Materials and Methods: This observational cohort study included 17 patients who underwent PTCA in LMCA during one-year study period at tertiary care centers in Government Medical College, Kozhikode, India. Data including various risk factors, clinical and angiographic details, stent used, procedural complications and outcomes including rate of restenosis were analyzed. Results: A total of 17 patients (mean age 53.88 ± 9.80 years) with 76.47% of males were included in the study. Smoking and hypertension were the most common risk factors presented in 52.94% and 47.06% of patients respectively. Single vessel disease (SVD) of LMCA was the most common pattern observed in 47.10%;the rate of restenosis was observed in 11.76% patients. Revascularization was performed in one patient (5.88%) with coronary artery bypass graft and in one patient (5.88%) with PTCA using drug eluting stent (DES). The overall procedural success was 88.24% in this study. Survival rate was 100% at one-year follow-up period. Conclusion: Our study involved patients who underwent PTCA in LMCA, showed smoking as a most prevalent risk factor for coronary artery disease and SVD as a most common pattern, comparatively low rate of restenosis and 100% of survival rate at one-year follow-up period. 展开更多
关键词 CORONARY ARTERY disease Drug Eluting stent In-stent RESTENOSIS Left Main CORONARY ARTERY Percutaneous TRANSLUMINAL CORONARY angioplasty
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Comparison of pre-dilation with a non-compliant balloon versus a dual wire scoring balloon for coronary stenting
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作者 Kenji Sadamatsu Keiki Yoshida +3 位作者 Yuya Yoshidomi Yasuaki Koga Kaori Amari Tomotake Tokunou 《World Journal of Cardiovascular Diseases》 2013年第6期395-400,共6页
Purpose: The aim of this study was to determine the influence of lesion preparation using the dual wire scoring balloon on stent expansion and long-term outcomes. Methods: Forty-six consecutive de novo lesions treated... Purpose: The aim of this study was to determine the influence of lesion preparation using the dual wire scoring balloon on stent expansion and long-term outcomes. Methods: Forty-six consecutive de novo lesions treated with a single >2.5 mm drug-eluting stent under intravascular ultrasound guidance, using two implantation strategies, were randomly assigned to: 1) pre-dilation with a non-compliant balloon (NC group;n = 23) or 2) pre-dilation with a dual wire scoring balloon (DS group;n = 23). Results: Although the balloon size and the maximal dilation pressure for pre-dilatation was larger (3.33 ± 0.28 vs 3.09 ± 0.33 mm, p = 0.01) and higher (11.6 ± 3.2 vs 8.6 ± 2.7 atm, 展开更多
关键词 INTRAVASCULAR Ultrasound stent Coronary Artery disease RESTENOSIS angioplasty
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PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY FOR COMPLICATED CORONARY ARTERY LESIONS
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作者 Huang Zhengwen Zhao Guoan Li Sufen Li Hongjun Department of Cardiovascular,First Affiliated Hospital.Xinxiang Medical College.Henan 453100,China 《中国介入心脏病学杂志》 1998年第4期153-153,共1页
Objective To research the effect of percutaneous transluminalcoronary angioplasty (PTCA) on treating complicated artery lesions.Methods Type B or type C of complicated coronary artery lesionswere confirmed by selectiv... Objective To research the effect of percutaneous transluminalcoronary angioplasty (PTCA) on treating complicated artery lesions.Methods Type B or type C of complicated coronary artery lesionswere confirmed by selective coronary angingraphy in 16 cases with coronaryheart disease.Gruentzig’s method was used in carring out PTCA.Results Fifteen of sixteen and thirty-two of thirty-five parts ofcoronary artery lesions were dilated successfully,the success rate was 93.7%and 88.5%,respectively.In failed four parts of PTCA,three parts werebecause of the guilding wire or the balloon failed to pass the narrow arterythrough,the other one was unable to be performed for the occurrencedsevere arrthymia during the procedure.Four stents were implantend foracute accident.Symptoms of the successful cases were improved ordisappeared after PTCA.Conclusion PTCA is also fit in treating complicated coronary arterylesions and has a better therapeutic effect,but it has more complications andrun more risks relatively. 展开更多
关键词 CORONARY ARTERY disease COMPLICATED CORONARY ARTERY lesions PERCUTANEOUS translumlnal CORONARY angioplasty stent treatement
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Efficacy of Different Types of Self-expandable Stents in Carotid Artery Stenting for Carotid Bifurcation Stenosis
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作者 刘亚民 秦皓 +3 位作者 张波 王毓婧 冯骏 吴翔 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2016年第1期95-98,共4页
Both open and closed loop self-expandable stents were used in carotid artery stenting(CAS) for carotid bifurcation stenosis. We sought to compare the efficacy of two types of stents in CAS. The data of 212 patients ... Both open and closed loop self-expandable stents were used in carotid artery stenting(CAS) for carotid bifurcation stenosis. We sought to compare the efficacy of two types of stents in CAS. The data of 212 patients treated with CAS(42 and 170 cases implanted with closed and open loop stents, respectively) for carotid bifurcation stenosis and distal filtration protection devices were retrospectively analyzed. Between closed and open loop stents, there were no significant differences in hospitalization duration, NIHSS score before and after the treatment, stenosis at 12 th month, and cumulative incidence of primary endpoint events within 30 days or from the 31 st day to the 12 th month; while there were significant differences in hemodynamic changes and rate of difficulty in recycling distal filtration protection devices. Use of open vs. closed loop stents for carotid bifurcation stenosis seems to be associated with similar incidence of complications, except for greater rate of hemodynamic changes and lower rate of difficulty in recycling the distal filtration protection devices. 展开更多
关键词 stroke artery occlusion diseases carotid artery stent intervention self-expandable stents
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Effects and Operating Experience of Percutaneous Transluminal Coronary Angioplasty in 63 cases
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作者 Guoxiang He Maoqm Shu Zhiyuan Song Department of Cardiology,Southwest Hospital,Third Military Medical University,Chongqing 400038, P.R.China 《中国介入心脏病学杂志》 1998年第4期152-152,共1页
Objective:To evaluate the effects of percutaneoustransluminal coronary angioplasty(PTCA) and intracoronarystents.Methods:PTCA was performed in 63 patients with 107diseased vessels and 121 lesions.Results:Effective dil... Objective:To evaluate the effects of percutaneoustransluminal coronary angioplasty(PTCA) and intracoronarystents.Methods:PTCA was performed in 63 patients with 107diseased vessels and 121 lesions.Results:Effective dilatation was performed in 79 of the107 diseased vessels and 103 of the 121 lesions,type Alesions were 25(24.3%);type B and C 78(75.7%).Theaverage dilatation time was 3.6±2.8,the average dilatationduration was 68±98 secondes and the average maxiumdilatation pressure was 8.5±2.9 atm.The average severity ofthe coronary artery stenosis decreased from 90% to 6%,thestenosis was disappeared completely in 93 lesions afterPTCA.Forty-one coronary stents were implanted with theaim of treating acute vessels occlusion in 2 cases andpreventing restenosis after PTCA in 32 cases.The ischemicST-T Changes of ECG and symptoms were improvedsignificantly in these patients post-PTCA.Conclusion:PTCA is a safe and effective therapy for thepatients with coronary heart disease,and coronary stent is avery effective method to treat acute coronary occlusionduring PTCA. 展开更多
关键词 RESTENOSIS DILATATION diseased stent angioplasty SEVERITY implanted OCCLUSION treating
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锁骨下动脉完全闭塞的腔内治疗:单中心回顾性研究
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作者 杨心志 牛国晨 +4 位作者 李鹏宇 姚子平 张碧辉 闫子光 杨敏 《中国血管外科杂志(电子版)》 2024年第1期64-67,共4页
目的探讨腔内治疗锁骨下动脉完全闭塞的有效性和远期通畅率。方法回顾性收集2018年6月至2023年6月北京大学第一医院38例行腔内治疗的锁骨下动脉完全闭塞患者临床资料,分析患者的手术成功率、并发症、症状缓解率和随访通畅率。结果技术... 目的探讨腔内治疗锁骨下动脉完全闭塞的有效性和远期通畅率。方法回顾性收集2018年6月至2023年6月北京大学第一医院38例行腔内治疗的锁骨下动脉完全闭塞患者临床资料,分析患者的手术成功率、并发症、症状缓解率和随访通畅率。结果技术成功率为92.1%(35/38),其中顺行及逆行再通的成功率分别为78.9%(30/38)和62.5%(5/8)。病变近端残端形态分型平钝型开通成功率比鸟嘴型更低(66.6%比94.1%,P=0.039)。症状缓解率为93.5%(29/31),无围手术期并发症发生。患者术后随访6~68个月,中位随访时间38个月,6例患者出现再狭窄,Kaplan-Meier分析显示术后5年通畅率为77.4%,未发现锁骨下动脉闭塞患者远期通畅率的独立预后因素。结论腔内治疗锁骨下动脉完全闭塞安全有效,远期通畅率较高。 展开更多
关键词 动脉闭塞性疾病 锁骨下动脉 腔内治疗 支架
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不同病因急性前循环大血管闭塞血管内治疗效果分析
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作者 周星辰 赵彪 +3 位作者 王大巍 张辉 王昊 闵敬亮 《中国现代神经疾病杂志》 CAS 北大核心 2024年第9期758-764,共7页
目的对比分析大动脉粥样硬化与单纯性动脉栓塞致前循环大血管闭塞血管内治疗的临床结局。方法纳入2020年8月至2022年9月蚌埠医科大学第二附属医院收治的87例急性前循环大血管闭塞患者,均行血管内治疗,包括静脉溶栓、支架取栓术、抽吸取... 目的对比分析大动脉粥样硬化与单纯性动脉栓塞致前循环大血管闭塞血管内治疗的临床结局。方法纳入2020年8月至2022年9月蚌埠医科大学第二附属医院收治的87例急性前循环大血管闭塞患者,均行血管内治疗,包括静脉溶栓、支架取栓术、抽吸取栓术或血管成形术(球囊扩张术或支架植入术),根据术中所见(病因)分为大动脉粥样硬化组(LAA组,32例)和单纯性动脉栓塞组(栓塞组,55例)。主要结局指标为术后90d神经功能预后[改良Rankin量表(mRS)],次要结局为术后血管再通率[改良脑梗死溶栓血流分级(mTICI)]和术后1d症状性脑出血发生率。结果栓塞组患者房颤(χ^(2)=17.672,P=0.000)和取栓次数≥3次(χ^(2)=10.606,P=0.001)比例高于LAA组,静脉溶栓比例低于LAA组(χ^(2)=5.403,P=0.020),而两组发病至手术时间(Z=1.111,P=0.267)、入院至手术时间(Z=0.149,P=0.882)、血管内治疗首选术式(Fisher确切概率法:P=0.153),以及主要结局术后90d神经功能预后良好(mRS评分≤2分)率(χ^(2)=0.004,P=0.950)和病死率(χ^(2)=0.035,P=0.851)、次要结局术后血管再通(mTICI分级≥Ⅱb级)率(χ^(2)=0.033,P=0.856)和术后1d症状性脑出血发生率(χ^(2)=0.345,P=0.557)差异均无统计学意义。结论大动脉粥样硬化与单纯性动脉栓塞致前循环大血管闭塞血管内治疗效果和临床预后相当。 展开更多
关键词 动脉闭塞性疾病 脑动脉疾病 支架 球囊和椭圆囊 血栓切除术 脑血管造影术
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PTA治疗慢性下肢动脉硬化闭塞症的疗效及支架内再狭窄的影响因素分析
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作者 熊开军 金成勇 +3 位作者 何虎强 江琰 罗晗峰 袁梦 《川北医学院学报》 CAS 2024年第3期367-370,共4页
目的:探究经皮腔内血管成形术(PTA)治疗慢性下肢动脉硬化闭塞症(ASO)的疗效及支架内再狭窄的影响因素。方法:回顾性分析行PTA治疗的97例慢性下肢ASO患者的临床资料,分析不同时间踝肱指数(ABI)、血流动力学指标[足背动脉内径、血流速度... 目的:探究经皮腔内血管成形术(PTA)治疗慢性下肢动脉硬化闭塞症(ASO)的疗效及支架内再狭窄的影响因素。方法:回顾性分析行PTA治疗的97例慢性下肢ASO患者的临床资料,分析不同时间踝肱指数(ABI)、血流动力学指标[足背动脉内径、血流速度峰值、血流量]、血清生化指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、超敏C反应单蛋白(hs-CRP)]变化,1年后随访再狭窄情况并分析相关影响因素。结果:慢性下肢ASO患者术后7 d、6个月、1年ABI、足背动脉内径和血流量均高于术前(P<0.05),血流速度峰值均低于术前(P<0.05);术后1年,ABI均低于术后7 d和6个月(P<0.05),足背动脉内径低于术后7 d(P<0.05),血流速度峰值高于术后7 d(P<0.05);血管再狭窄者31例(31.96%),未狭窄者66例(68.04%);再狭窄组术前ABI、术后1年高密度脂蛋白胆固醇(HDL-C)均低于未狭窄组(P<0.05);植入支架≥2个比率、术前甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、术后1年TG、LDL-C、超敏C反应蛋白(hs-CRP)均高于未狭窄组(P<0.05),植入支架长度大于未狭窄组(P<0.05);术前ABI、TG、LDL-C和术后1年TG、LDL-C、HDL-C、hs-CRP均为下肢ASO患者支架内再狭窄的危险因素(P<0.05)。结论:PTA治疗慢性下肢ASO短期疗效显著,但有术后再狭窄风险,术前ABI、TG、LDL-C,术后TG、LDL-C、HDL-C、hs-CRP水平均为下肢ASO患者支架内再狭窄的危险因素。 展开更多
关键词 慢性下肢动脉硬化闭塞症 经皮腔内血管成形术 支架内再狭窄 血流动力学
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腔内血管成形支架植入术治疗对大脑中动脉闭塞患者神经功能的影响
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作者 沈东炜 邱平 胡方进 《中国医药指南》 2024年第14期121-123,共3页
目的分析腔内血管成形支架植入术治疗对大脑中动脉闭塞患者神经功能的影响。方法以我院在2018年1月至2023年9月收治的80例大脑中动脉闭塞患者为对象进行回顾性分析,80例患者实施腔内血管成形支架植入术治疗。比较治疗前后的神经功能、... 目的分析腔内血管成形支架植入术治疗对大脑中动脉闭塞患者神经功能的影响。方法以我院在2018年1月至2023年9月收治的80例大脑中动脉闭塞患者为对象进行回顾性分析,80例患者实施腔内血管成形支架植入术治疗。比较治疗前后的神经功能、生活能力、预后质量、生物标志物水平,统计并发症发生情况。结果治疗1个月后,80例患者NIHSS、MRS评分均低于治疗前(均P<0.05);治疗1个月后,80例患者ADL、GOS评分均高于治疗前(均P<0.05);治疗1个月后,80例患者NSE、ET-1、PCT、TNF-α水平均低于治疗前(均P<0.05);80例患者治疗后并发症总发生率为5.00%(4/80),包括出血2例、切口感染1例、动脉夹层1例。结论对于大脑中动脉闭塞的患者,腔内血管成形支架植入术是一种有效且相对安全的治疗方法,可显著改善患者的神经功能和生活质量。 展开更多
关键词 腔内血管成形支架植入术 大脑中动脉闭塞 神经功能
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介入放射学诊治糖尿病性外周动脉病变的价值
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作者 曹积善 《中外医药研究》 2024年第2期63-65,共3页
目的:探究介入放射学诊治糖尿病性外周动脉病变(PAD)的价值。方法:选取2019年10月-2022年10月在海西州人民医院就诊的PAD患者60例作为研究对象,以随机数字表法分为对照组和观察组,各30例。对照组采用彩色多普勒超声检查联合药物进行治疗... 目的:探究介入放射学诊治糖尿病性外周动脉病变(PAD)的价值。方法:选取2019年10月-2022年10月在海西州人民医院就诊的PAD患者60例作为研究对象,以随机数字表法分为对照组和观察组,各30例。对照组采用彩色多普勒超声检查联合药物进行治疗,观察组采用介入放射学进行诊治。比较两组空腹血糖、餐后2h血糖、糖化血红蛋白、治疗效果、经皮血氧分压。结果:治疗后,观察组空腹血糖、餐后2h血糖、糖化血红蛋白水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率高于对照组,差异有统计学意义(P=0.006);治疗后6周,两组卧位时、坐位时、活动后经皮血氧分压均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:介入放射学在PAD的诊断和治疗中应用效果较好,可以明显改善患者的血糖指标,提高治疗效果,改善下肢缺血状态,值得临床推广。 展开更多
关键词 介入放射学 糖尿病性外周动脉病变 经皮腔内血管成形术 支架置入术
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症状性锁骨下动脉狭窄和闭塞的介入治疗 被引量:13
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作者 张曦彤 富宏 +2 位作者 王少雷 邵海波 徐克 《介入放射学杂志》 CSCD 2006年第5期270-273,共4页
目的评价症状性锁骨下动脉狭窄和闭塞介入治疗方法。方法32例锁骨下动脉狭窄和闭塞,其中锁骨下动脉狭窄19例,闭塞13例。27例有上肢缺血,7例伴头部缺血。应用导丝开通,PTA及内支架置入方法进行治疗。结果28例开通成功。术中发生脑梗死1... 目的评价症状性锁骨下动脉狭窄和闭塞介入治疗方法。方法32例锁骨下动脉狭窄和闭塞,其中锁骨下动脉狭窄19例,闭塞13例。27例有上肢缺血,7例伴头部缺血。应用导丝开通,PTA及内支架置入方法进行治疗。结果28例开通成功。术中发生脑梗死1例。单纯PTA治疗3例,1例上肢缺血症状部分好转。24例置入内支架后症状、体征明显改善。18例有锁骨下动脉窃血征象,术后16例消失。27例随访2~80个月,平均(29.5±21.0)个月。术后9个月闭塞2例,1例PTA后再获通畅。术后12个月闭塞1例,改行外科手术治疗。1例大动脉炎于术后9个月死于心功能衰竭。余在随访期内均无症状再发,超声Dopplor检查均通畅。结论介入方法可有效治疗症状性锁骨下动脉狭窄、闭塞。 展开更多
关键词 狭窄 闭塞 锁骨下动脉 血管扩张成型 内支架 介入治疗
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血管内成形术和支架植入术治疗症状性颅内动脉狭窄 被引量:10
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作者 田会铭 佟小光 +2 位作者 康伟民 尚彦国 水涛 《中国现代神经疾病杂志》 CAS 2010年第5期557-562,共6页
目的评价经皮血管内成形术和支架植入术治疗症状性颅内动脉狭窄的安全性、有效性和中短期疗效。方法 24例颅内动脉狭窄患者行经皮血管内成形术和支架植入术,其中颈内动脉颅内段狭窄6个,大脑中动脉狭窄7个,基底动脉及椎动脉颅内段狭窄11... 目的评价经皮血管内成形术和支架植入术治疗症状性颅内动脉狭窄的安全性、有效性和中短期疗效。方法 24例颅内动脉狭窄患者行经皮血管内成形术和支架植入术,其中颈内动脉颅内段狭窄6个,大脑中动脉狭窄7个,基底动脉及椎动脉颅内段狭窄11个。20例植入Wingspan支架,2例因Gateway球囊扩张满意而未植入支架,2例椎动脉颅内段狭窄者分别植入Apollo及Invastent Volo球囊支架。结果经皮血管内成形术和支架植入术后,患者血管狭窄率由手术前60%~95%降为手术后残余狭窄率0~20%。23例随访2~24个月,效果良好,未见复发。2例植入Wingspan支架后1~3 h出现脑出血,1例死亡,1例轻度偏瘫,死残率为8.33%。结论经皮血管内成形术和支架植入术治疗症状性颅内动脉狭窄有效,中短期疗效满意。在严格的准入标准下,Gateway球囊-Wingspan支架植入围手术期仍有严重并发症出现,值得关注。 展开更多
关键词 颅内动脉疾病 动脉闭塞性疾病 血管成形术 支架 脑血管造影术
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