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26例TASC(Ⅱ)D型股动脉闭塞腔内治疗临床分析

刘存发1,张秀军2   

  1. 1. 天津市天和医院
    2. 天津市天津医院
  • 收稿日期:2013-09-25 修回日期:2014-03-07 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 张秀军

Clinical Analysis of Endovascular Treatment of TASC (Ⅱ) D-Type Femoral Artery Occlusion

lcunfa liu1, Xiujun ZHANG2   

  1. 1. Department of Vascular Surgery, Tianjin Hospital, Tianjin300211, China
    2.
  • Received:2013-09-25 Revised:2014-03-07 Published:2014-08-15 Online:2014-08-15
  • Contact: Xiujun ZHANG

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摘要： 【摘要】目的  探讨TASC（Ⅱ）D型股动脉闭塞的腔内治疗方法及效果。方法  回顾性分析2012年1月—2013年5月采用腔内治疗TASC(Ⅱ)D型股浅动脉闭塞26例（26肢）患者的临床资料。其中采用球囊扩张内支架置入13例（裸支架组，共植入支架31枚）、Silverhawk斑块旋切6例（Silverhawk斑块旋切组）、Viabahn覆膜支架2例（Viabahn覆膜支架组）。腔内手术未成功通过病变者5例给予前列地尔等扩血管药物治疗。通过手术前后踝肱指数(ABI)、螺旋CT血管成像（CTA）、数字减影血管造影（DSA）及症状改善情况来评价疗效；并于术后6个月复查CTA。结果  26例中成功开通目标动脉21例（技术成功率80.7%），造影证实血流通畅，残留狭窄小于30%，术后患肢缺血症状缓解。术后1周ABI高于术前（0.77±0.10vs0.43±0.15，t=7.948，P＜0.05）。6个月一期通畅比例分别为裸支架组9/13，Silver?hawk斑块旋切组4/6，Viabahn覆膜支架2/2。结论  腔内治疗TASC（Ⅱ）D型股动脉闭塞可提高近期通畅率Viabahn覆膜支架是治疗的新手段。

关键词: 股动脉闭塞, 裸支架, Silverhawk斑块旋切, Viabahn覆膜支架

Abstract: [Abstract] Objective   To investigate methods and results of endovascular treatment in TASC (Ⅱ) D-type femoral
artery occlusion.Methods   From January2012to May 2013, 26cases (26branches) of superficial femoral artery occlusion with endovascular treatment of TASC (Ⅱ) D-type superficial femoral artery occlusion were retrospectively reviewed. The effi?cacy was evaluated through ABI, CTA, DSA and symptoms improved.Results   26branches were treated with endovascular methods. Technical success rate was80.7% (21/26), including 13branche with stent implantation,6branches with Silver?hawk atherectomy and2branches with Viabahn stent implantation．All patients were followed up for a mean period of（10.3±1.2）months, primary patency rates at6months were69.2% in stent group,66.7% in Silverhawk atherectomy group and100% in Viabahn stent group.Conclusion   Endovascular treatment of TASC (Ⅱ) D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment.

Key words: femoral artery occlusion, stent, silverhawk atherectomy, viabahn stent