中国实用外科杂志

中国实用外科杂志

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下肢动脉硬化闭塞症血管腔内治疗热点问题

王深明，姚    陈   

  1. 中山大学附属第一医院血管外科，广东广州510080
  • 出版日期:2016-12-01 发布日期:2016-12-01

  • Online:2016-12-01 Published:2016-12-01

摘要：

下肢动脉硬化闭塞症（ASO）严重威胁人类健康。血管腔内治疗是目前治疗ASO的主要手段，美国心脏病学院和美国心脏协会（ACC/AHA）等多个国际权威指南都提出腔内治疗优先的原则。权威指南对于腔内治疗不断进行规范，极大地改善了疗效。但是，血管腔内治疗仍面临术后再狭窄发生率高等难题。近年来，以药物涂层球囊（DCB）和药物洗脱支架（DES）为代表的新器械的问世大大改善了腔内治疗的效果。尽管如此，DCB的优势能否使病人受益，目前仍有争议。因此，血管外科医生须在采取规范化腔内治疗措施基础上，不断更新理念，合理应用新器械以进一步提高ASO血管腔内治疗效果。

关键词: 动脉硬化闭塞症, 血管腔内治疗, 药物涂层球囊

Abstract:

Hot issues of endovascular therapy for arteriosclerosis obliterans        WANG Shen-ming，YAO Chen. Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Corresponding author：WANG Shen-ming，E-mail: wshenm@
mail.sysu.edu.cn
Abstract    Arteriosclerosis obliterans (ASO) is a major source of morbidity and mortality. Endovascular therapy has become the first-line strategy for ASO cases. Currently, ACC/AHA and many other guidelines recommend endovascular therapy as the first choice for ASO. Those guidelines standardize the endovascular treatment for ASO and improve the clinical results. But those advances of endovascular therapy have been limited by high rates of clinical restenosis. Recently, drug-coated balloons and drug-eluting stents have emerged as an exciting technology developed to reduce the restenosis rate. However, it remains unknown whether those improved results can translate into beneficial clinical outcomes. The endovascular therapy should be standardized according to the guidelines. Vascular surgeons need to update the concept and use new technologies properly to improve clinical outcomes.

Key words: arteriosclerosis obliterans, endovascular therapy, drug-coated balloon