腔内治疗在主髂动脉硬化闭塞症中的应用
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金星Email:jinxing_888@163.com

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山东省自然科学基金资助项目(Y2003C06)。


Endovascular treatment |for aortoiliac occlusive disease
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    摘要:

    目的:探讨主髂动脉硬化闭塞症腔内治疗的技术要点及其疗效。
    方法:回顾性分析主髂动脉硬化闭塞患者113例临床资料,其中男79例,女34例,年龄45岁~81(平均62.5)岁。TASC A型42例(37.17%),B型39例(34.51%),C型患者13例(11.50%),D型患者19例(16.81%)。腔内治疗经股动脉或肱动脉入路,采用通过闭塞段、球囊扩张、支架放置及股总动脉内膜剥脱等方法进行治疗。
    结果:107例患者主髂动脉闭塞病变获开通,开通率为94.7%。68例患者临床症状明显改善,39例中度改善,。平均随访(26±2.3)个月(6~54个月),术后6个月,1,2年的初次通畅率分别为82.76%,76.21%,67.66%,术后6个月,1,2年的二次通畅率分别为92.31%,81.67%,73.62%。
    结论:对于主髂动脉硬化闭塞的患者,综合应用多种方法进行腔内治疗是一项安全有效的措施,可获得满意的临床疗效。

    Abstract:

    Objective:To explore the effect of endovascular treatment for aortoiliac occlusive disease (AIOD).
    Methods:The clinical data of 113 patients with AIOD, who underwent endovascular treatment, were retrospectively analyzed.The patients’mean age was 62.5 years (range, 45 to 81 years);79 patients (69.9%) were men and 39 women.According to the Trans Atlantic InterSociety Consensus classfication, type A, B,C and D disease was respectively present in 37.17%,34.51%,11.50% and 16.81% of patients. With the approach from femoral artery or brachial artery, combined techniques, such as recanalization, balloon dilation, stent placement and concomitant common femoral endarterectomy, were applied in the treatment. 
    Results:Technical success was achieved in 107 patients(94.7%). Clinical status was moderately improved in 39 cases and markedly improved in 68 cases. Mean time of followup was (26±2.3) months. At 6 months, primary patency of the occlusive artery was 82.76%, and secondary patency was 92.31%. At 12 months, primary patency was 76.21%and secondary patency was 81.67%. At 24 months, primary patency was 67.66% and secondary patency was 73.62%.
    Conclusions:Combined multiple endovascular techniques are safe and effective methods in treatment of aortoiliac occlusive disease.

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齐加新, 邹萍, 金星, 张十一, 袁海, 张精勇, 黄俊荣, 张蕾.腔内治疗在主髂动脉硬化闭塞症中的应用[J].中国普通外科杂志,2010,19(6):597-601.
DOI:10.7659/j. issn.1005-6947.2010.06.001

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  • 收稿日期:2010-04-05
  • 最后修改日期:2010-05-10
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  • 在线发布日期: 2010-06-15