中国实用外科杂志

中国实用外科杂志 ›› 2008, Vol. 28 ›› Issue (10): 866-868.

• 论著 • 上一篇    下一篇

膝下动脉闭塞症的腔内治疗

徐欣，张文波，杨珏，陈斌，竺挺，符伟国   

  1. 复旦大学附属中山医院血管外科，上海200032
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2008-10-01 发布日期:2008-10-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2008-10-01 Published:2008-10-01

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摘要：

目的探讨腔内术对膝下动脉闭塞疾病的治疗价值。方法回顾性分析2006年2月至2008年5月复旦大学附属中山医院血管外科收治的86例患有膝下动脉闭塞症的住院病人的病史资料和术后随访资料。结果86例病人（90条患肢）经经皮腔内血管成形术（PTA）治疗，82条患肢获得影像学成功（残留狭窄率＜30%）。技术成功率为911%（82/90）。术前1周和术后1周行下肢节段测压，踝肱指数（ABI）由术前的034±016提高到085±023。1年累计初次通畅率为612%，24月累积初次通畅率为495%，肢体保全率978%，存活率978%。结论PTA治疗膝下动脉闭塞症临床成功率高，并发症少，保肢率高，可以作为膝下动脉闭塞特别是重症肢体缺血的首选。

关键词: 腔内术, 血管成形, 膝下动脉闭塞, 重症肢体缺血

Abstract:

Value of percutaneous transluminal angioplasty in the treatment of infrapopliteal arterial occlusive diseasesXU Xin,ZHANG Wenbo,YANG Jue,et al.Department of Vascular Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China Corresponding author:FU Weiguo，Email:fu.weiguo@zshospital.sh.cn AbstractObjectiveTo investigate the value of endovascular surgery in the treatment of infrapopliteal arterial occlusive diseases.MethodsThe clinical and followup data of 86 patients (90 limbs) with infrapopliteal arterial occlusive diseases admitted between February 2006 and May 2008 in the Department of Vascular Surgery of Zhongshan Hospital of Fudan University were analyzed retrospectively.ResultsEightysix patients (90 limbs) were treated by percutaneous transluminal angioplasty (PTA).Angiographic success on the limb basis was achieved in 82 of 90 treated limbs (defined as the residual stenosis of the treated segment was less than 30%) and the initial technical success rate was 911%.Doppler anklebrachial index (ABI) increased from 034±016 to 085±023 (pre vs. post).The 12month accumulated primary patency rate,24month accumulated primary patency rate,survival rate and limb salvage rate were 612%，495%,978% and 978% respectively.ConclusionPTA is feasible as a primary invasive treatment for infrapopliteal arterial occlusive lesions in patients with chronic critical limb ischemia, yielding acceptable primary clinical success with a low complication rate and resulting in　moderate longterm clinical patency and a high limb salvage rate．

Key words: sendovascular surgery；angioplasty；infrapopliteal arterial occlusive, critical limb ischemia