摘要
目的比较股浅动脉狭窄闭塞长段病变一期置入自膨式支架与一期球囊扩张成形的中期疗效。方法回顾性分析2005年12月至2007年2月收治的症状性股浅动脉硬化狭窄或闭塞109例患者的临床资料，其中支架组53例（73条肢体）首期置入自膨式支架；扩张组56例（76条肢体）首期单纯球囊扩张成形。比较患者术后6、12及24个月的再狭窄、再闭塞率及临床分级改善程度。结果支架组与扩张组的治疗段平均长度分别为（16±8）cm和（15±7）cm；经血管超声检查支架组与扩张组术后6个月再狭窄率分别为13．7％（7例）和30．2％（16例），两组差异有统计学意义（χ^2=4．09，P〈0．05）；12个月分别为25．5％（12例）和46．9％（23例），两组差异有统计学意义（χ^2=4．75，P〈0．05）；24个月分别为38．1％（16例）和65．9％（29例），两组差异有统计学意义（χ^2=6．66，P〈0．01）；且支架组较扩张组临床分级改善显著而持久。结论对于股浅动脉硬化狭窄或闭塞长段病变，首期置入自膨式支架的中期疗效较单纯球囊扩张血管成形术更为理想。
Objective To compare the mid-term clinical results of primary implantation of a self- expanding nitinol stent and primary percutaneous transluminal angioplasty （PTA） for long range arteriosclerosis obliterans of the superficial femoral artery. Methods From December 2005 to February 2007,109 patients who had moderate-severe claudication or chronic limb ischemia （CLI）due to stenosis or occlusion of the superficial femoral artery were treated by endovascular technology. 53 patients （ 73 limbs ） were treated by primary stenting and 56 patients （76 limbs）by PTA. We compared the clinical data of stenting group and PTA group at 6,12 and 24 months. Results The mean length of the treated segment was （ 16 ± 8 ） cm in the stenting group and（ 15 ± 7 ） em in the PTA group. At 6 months, the rate of restenosis on duplex ultrasonography was 13.7% in stenting group and 30. 2% in PTA group （ χ^2 = 4. 09, P 〈 0. 05 ） ; at 12 months the restenosis rates were 25.5% in stenting group and 46. 9% in PTA group（ χ^2 = 4. 75 ,P 〈 0. 05 ） ; at 24 months the restenosis rates on duplex uhrasonography were 38. 1% in stenting group and 65.9% in PTA group （χ^2 = 6. 66, P 〈 0. 01 ）. Rutherford stages in stenting group were significantly better than those in PTA group. Conclusion In the mid-term, primary implantation of a self-expanding nitinol stent yielded results that were superior to those with PTA for arteriosclerosis obliterans or long range stenosis of the superficial femoral artery.
出处
《中华普通外科杂志》
CSCD
北大核心
2009年第6期455-458,共4页
Chinese Journal of General Surgery
关键词
动脉硬化
闭塞性
支架
移植物闭塞
血管
股动脉
Arteriosclerosis obliterans
Stents
Graft occlusion, vascular
Femoral artery
