中国实用外科杂志

中国实用外科杂志

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股浅动脉及近段腘动脉支架断裂危险因素分析

段润丹，谢    辉，吕    磊，周兆熊   

  1. 上海交通大学医学院附属仁济医院血管外科，上海200127
  • 出版日期:2017-06-01 发布日期:2017-05-31

  • Online:2017-06-01 Published:2017-05-31

摘要：

目的    探讨股腘动脉一期支架植入后支架断裂危险因素。方法    回顾性分析2013年3月至2016年3月上海交通大学医学院附属仁济医院收治的96例（106条患肢）股浅动脉及近段腘动脉行支架一期植入术后资料完整的随访病人临床资料，行双功彩色多普勒超声、X线平片、造影剂增强CT及数字减影血管造影（DSA）等影像学检查，并针对相关资料进行统计学分析。结果    平均随访（16±8.8）个月，支架断裂发生率为35.8%（38/106）。分层分析发现，泛大西洋协作组（TASC Ⅱ） D型病变、长段支架覆盖、支架间重叠区域增加都会导致支架断裂率升高。同时，研究发现发生率最高的断裂类型为Ⅱ型支架断裂，断裂发生率最高的部位为股浅动脉收肌管段。结论    TASC D型病变、长段支架覆盖及支架间重叠区域增加都是支架断裂重要危险因素。

关键词: 下肢动脉硬化闭塞症, 支架断裂, 再狭窄

Abstract:

Risk factors analysis of stent fracture after superficial femoral artery and proximal popliteal artery stenting               DUAN Run-dan, XIE Hui, LÜ Lei,et al. Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Corresponding author: ZHOU Zhao-xiong, E-mail: zhou_zhaoxiong@hotmail.com
Abstract    Objective    To study the risk factors of stent fracture，and determine the relationship between stent fracture and in-stent restenosis after superficial femoral artery and proximal popliteal artery stenting. Methods    From March 2013 to March 2016，96 consecutive patients （106 limbs） who underwent endovascular stenting therapy in superficial femoral artery and proximal popliteal artery were followed up by the methods of Doppler ultrasound scanning，X-ray scanning， computed tomographic angiography or digital subtraction angiography at Department of Vascular Surgery， Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Statistical analysis was performed by using SPSS. Results    Overall， stent fractures were detected in 38 of 106 treated legs （35.8%）. TransAtlantic Inter-Society Consensus(TASC) Ⅱclassification（P＜0.001）， total stent length（P＜0.001）， and increased overlap zone（P=0.01） were statistically significant risk factors of stent fracture. The research also found that the highest incidence of fracture type was multi-struts fracture, and the highest incidence of the targeted arterial segment was the superficial femoral artery adductor canal segment. Conclusion    TASC Ⅱclassification， total stent length and increased overlap zone were risk factors of stent fracture.

Key words: arteriosclerosis obliterans, stent fracture, in-stent restenosis