摘要
目的探讨双向内膜下血管成形术在治疗周围动脉完全闭塞性病变中的意义。方法采用双向内膜下血管成形术治疗5例长段动脉闭塞患者,其中腹主动脉下端合并两侧髂总动脉及髂外动脉闭塞1例,髂外动脉闭塞2例,股浅动脉闭塞2例。在单向内膜下再通时,进入真腔失败后而在患肢闭塞动脉远端血管穿刺,使用导丝从病变对侧进入闭塞段内膜下,在病变内膜下腔,采用导丝贯穿至对侧导管技术,成功后,将导丝从对侧导管引出体外,然后用球囊扩张成型并植入支架。结果本组5例患者均成功完成双向内膜下再通,共植入支架9枚。结论双向内膜下再通可以作为单向内膜下再通进入真腔失败时的补救方法,可有效提高血管成形术的成功率。
Objective To discuss the therapeutic efficacy of bidirectional subintimal angioplasty in the treatment of atherosclerotic occlusive of lower limbs. Methods Five patients with long segment of obstructed artery in lower limb were enrolled in the study. Of five patients, occlusion of the lower segment of abdominal aorta and bilateral iliac artery was seen in one, occlusion of iliac artery in 2 and occlusion of superficial femoral artery in the remaining two. Antegrade subintimal angioplasty procedure was unsuccessful in all five patients as the wire could not be placed into the true lumen, so retrograde subintimal angioplasty by puncturing the distal segment of the occlusive artery was employed. Through the newly created channel the retrograde guide wire was manipulated to be pulled out of vessel through the antegrade catheter. The subintimal tract was dilated with angioplasty balloon and the stent implantation was performed. Results Bidirectional subintimal angioplasty was successfully accomplished in all five patients, with a total of nine stents being implanted. Conclusion Bidirectional subintimal angioplasty is a safe and effective procedure for bringing the subintimal recanalization to success, this technique can be regarded as a remedial measure when unidirectional subintimal angioplasty ends up in failure. （J Intervent Radiol, 2009, 18： 727-729）
出处
《介入放射学杂志》
CSCD
北大核心
2009年第10期727-729,共3页
Journal of Interventional Radiology
关键词
动脉硬化
闭塞性
放射学
介入性
双向内膜下血管成形
arteriosclerosis, obliterans
radiology, interventional
bidirectional subintimal angioplasty
