摘要
目的探讨应用内膜下再通和覆膜支架植入术治疗髂动脉硬化闭塞病变的方法和疗效。方法5例伴有严重缺血症状的髂动脉完全闭塞病变患者,动脉闭塞长度2.5～12.0cm。采用顺行途径(经右肱动脉穿刺3例,经对侧股动脉穿刺2例)对闭塞段血管行意向性内膜下途径再通,用直径8mm球囊对内膜下通道扩张成形并植入镍钛合金覆膜支架,共植入覆膜支架6枚,另在1处狭窄病变植入覆膜支架1枚,1处长段闭塞病变覆膜支架远段和另1处髂动脉狭窄病变中各植入裸支架1枚。结果内膜下再通操作全部获技术成功,无并发症出现。覆膜支架置放后血管腔内形态良好,血流通畅。临床症状消失或明显改善。患肢踝臂指数(ABI)平均值由0.40±0.32上升至0.89±0.15。近中期随访无症状复发。结论动脉内膜下再通术联合覆膜支架植入术治疗髂动脉硬化闭塞病变安全、有效,近中期疗效良好。
Objective To explore the method and effectiveness of subintimal recanalization and covered stent treatment for total occlusion of iliac artery. Methods Five patients of iliac artery total occlusion with chronic critical limb ischemia underwent subintimal recanalization and subsequent covered stent placement. The occlusive length of artery was from 2.5 cm to 12.0 cm. Antegrade access was applied in all patients from different approach sites of right brachial artery or opposite femoral artery. After balloon angioplasty of the subintimal space, 6 eTPFE covered stents （Flency, Bard） were released in the subintimal path way all together. Another covered stent was used in an external lilac stenosis and 2 naked stents （Luminexx, Bard） were used separately at the distal end of the covered stent in a long occlusion and at a stenosis segment. Results Occluded iliac arteries of the 5 patients were successfully recanalized through subintimal space without any complication. Angiogram showed smooth inner shape of the stent. Clinical symptom of ischemia disappeared or improved. The mean value of ABI increased from 0. 40±0. 32 to 0. 89±0. 15. No symptom recurred during 8 to 24 months follow-up. Conclusion Subintimal recanalization and subsequent covered stent placement are effective to treat iliac artery total occlusion. Combined application of these methods benefits the success rate of recanalization and mid-term patency.
出处
《中国医学影像技术》
CSCD
北大核心
2009年第8期1467-1469,共3页
Chinese Journal of Medical Imaging Technology
关键词
髂动脉
闭塞
内膜下
再通
覆膜支架
Iliac artery
Occlusion
Subintimal
Recanalization
Covered stent
