Objective:To compare the safety and effectiveness of lower extremity artery bypass grafting and endovascular angioplasty in the treatment of lower extremity arteriosclerosis obliterans in the elderly.Methods:The data ...Objective:To compare the safety and effectiveness of lower extremity artery bypass grafting and endovascular angioplasty in the treatment of lower extremity arteriosclerosis obliterans in the elderly.Methods:The data of 87 elderly patients with lower extremity arteriosclerosis obliterans treated in our hospital from August 2015 to August 2017 were analyzed retrospectively.According to the different treatment methods,they were divided into angioplasty group(n=45,intravascular angioplasty)and bypass grafting group(n=42,lower extremity artery bypass grafting).The success rate,hemodynamics of dorsalis pedis artery and nerve conduction of lower extremity were compared between the two groups Velocity,VAS score,late target vessel lumen loss(LLL),patency rate,restenosis rate,ankle brachial index(ABI)and clinical adverse events.Results:There was no significant difference between angioplasty group and bypass group(P>0.05).One month after operation,the hemodynamics of dorsalis pedis artery and nerve conduction velocity of lower limbs in the two groups were better than those before operation,the difference was statistically significant(P<0.05),but there was no significant difference between the two groups(P>0.05).The VAS score of the two groups was significantly lower than that of the preoperative group(P<0.05),but there was no significant difference between the two groups(P>0.05).The ABI of the two groups was significantly improved after operation,the difference was statistically significant(P<0.05),but there was no significant difference between the groups at each time point(P>0.05).There was no significant difference in LLL,patency rate and restenosis rate between the two groups(P>0.05).There was statistical difference in the incidence of complications between the two groups(P<0.05).During the follow-up period,no serious adverse events such as death or amputation occurred in both groups.Conclusion:Endovascular angioplasty and lower extremity artery bypass grafting have the same clinical effect in the treatment of elderly patients with lower extremity arteriosclerosis obliterans,which are safe and feasible.展开更多
目的：探讨胸部小切口冠状动脉搭桥术的临床效果。方法2002年1月～2013年1月采用胸部小切口取左乳内动脉（ left internal mammary artery，LIMA）心脏不停跳冠状动脉搭桥术66例。胸骨下段小切口59例，采用全麻、单腔气管插管，平卧位...目的：探讨胸部小切口冠状动脉搭桥术的临床效果。方法2002年1月～2013年1月采用胸部小切口取左乳内动脉（ left internal mammary artery，LIMA）心脏不停跳冠状动脉搭桥术66例。胸骨下段小切口59例，采用全麻、单腔气管插管，平卧位，倒“L”胸骨下段切口；胸骨旁小切口5例，采用全麻、双腔气管插管，平卧位左胸抬高30＆#176;，左前外侧第4或第5肋切口，用特制牵开器（法国圣骑士公司）牵开肋骨，游离乳内动脉，使用冠脉固定器下行冠脉吻合；2例胸腔镜辅助下完成乳内动脉与左前降支的吻合。结果66例均完成左乳内动脉至前降支的吻合，2例追加大隐静脉降主动脉至第一对角支的吻合。无围术期死亡。60例随访0．5～8年，（5．5±2．5）年，心绞痛症状消失42例，明显减轻24例。术后冠状动脉CT检查16例，冠脉造影12例，LIMA与左前降支（ left anterior descending， LAD）吻合口满意率100％，支架内再狭窄1例，大隐静脉桥血管闭塞1例。结论胸部小切口冠状动脉搭桥术主要适用于心脏前壁冠状动脉尤其是前降支的的再血管化，安全可靠，中期疗效好，在合并高危因素或常规冠状动脉搭桥术和经皮冠状动脉介入术效果不满意者中应用更佳。展开更多
文摘Objective:To compare the safety and effectiveness of lower extremity artery bypass grafting and endovascular angioplasty in the treatment of lower extremity arteriosclerosis obliterans in the elderly.Methods:The data of 87 elderly patients with lower extremity arteriosclerosis obliterans treated in our hospital from August 2015 to August 2017 were analyzed retrospectively.According to the different treatment methods,they were divided into angioplasty group(n=45,intravascular angioplasty)and bypass grafting group(n=42,lower extremity artery bypass grafting).The success rate,hemodynamics of dorsalis pedis artery and nerve conduction of lower extremity were compared between the two groups Velocity,VAS score,late target vessel lumen loss(LLL),patency rate,restenosis rate,ankle brachial index(ABI)and clinical adverse events.Results:There was no significant difference between angioplasty group and bypass group(P>0.05).One month after operation,the hemodynamics of dorsalis pedis artery and nerve conduction velocity of lower limbs in the two groups were better than those before operation,the difference was statistically significant(P<0.05),but there was no significant difference between the two groups(P>0.05).The VAS score of the two groups was significantly lower than that of the preoperative group(P<0.05),but there was no significant difference between the two groups(P>0.05).The ABI of the two groups was significantly improved after operation,the difference was statistically significant(P<0.05),but there was no significant difference between the groups at each time point(P>0.05).There was no significant difference in LLL,patency rate and restenosis rate between the two groups(P>0.05).There was statistical difference in the incidence of complications between the two groups(P<0.05).During the follow-up period,no serious adverse events such as death or amputation occurred in both groups.Conclusion:Endovascular angioplasty and lower extremity artery bypass grafting have the same clinical effect in the treatment of elderly patients with lower extremity arteriosclerosis obliterans,which are safe and feasible.
文摘目的：探讨胸部小切口冠状动脉搭桥术的临床效果。方法2002年1月～2013年1月采用胸部小切口取左乳内动脉（ left internal mammary artery，LIMA）心脏不停跳冠状动脉搭桥术66例。胸骨下段小切口59例，采用全麻、单腔气管插管，平卧位，倒“L”胸骨下段切口；胸骨旁小切口5例，采用全麻、双腔气管插管，平卧位左胸抬高30＆#176;，左前外侧第4或第5肋切口，用特制牵开器（法国圣骑士公司）牵开肋骨，游离乳内动脉，使用冠脉固定器下行冠脉吻合；2例胸腔镜辅助下完成乳内动脉与左前降支的吻合。结果66例均完成左乳内动脉至前降支的吻合，2例追加大隐静脉降主动脉至第一对角支的吻合。无围术期死亡。60例随访0．5～8年，（5．5±2．5）年，心绞痛症状消失42例，明显减轻24例。术后冠状动脉CT检查16例，冠脉造影12例，LIMA与左前降支（ left anterior descending， LAD）吻合口满意率100％，支架内再狭窄1例，大隐静脉桥血管闭塞1例。结论胸部小切口冠状动脉搭桥术主要适用于心脏前壁冠状动脉尤其是前降支的的再血管化，安全可靠，中期疗效好，在合并高危因素或常规冠状动脉搭桥术和经皮冠状动脉介入术效果不满意者中应用更佳。
