摘要
目的评估Rotarex减容联合药物涂层球囊治疗股腘动脉支架内再闭塞(in-stent occlusion,ISO)的临床疗效。方法回顾性分析2018年9月至2021年1月我院收治的12例股腘动脉ISO患者的临床资料,均行Rotarex减容联合药物涂层球囊治疗。术后3、6、12个月使用多普勒超声检查随访。结果本组患者病变长度为80~170 mm,平均(118.58±25.27)mm,单纯股浅动脉ISO 8例,合并腘动脉病变4例。12例患者均成功完成治疗,术中无动脉破裂穿孔,术后无穿刺点并发症发生,无心脑血管意外及死亡病例。术后患者Rutherford分级下降,ABI由术前0.49±0.12增至术后0.93±0.10,均较术前明显增加,差异有统计学意义(P<0.05)。本组患者均完成随访,平均时间(12.08±3.78)个月。超声随访显示,靶血管再通后12个月一期通畅率为84.2%(10/12),12个月免于临床驱动的靶血管再干预率为91.7%(11/12)。1例患者再次出现临床症状并于术后第11个月行DCB处理后症状缓解。随访期间无死亡及截肢事件发生。结论Rotarex减容联合药物涂层球囊治疗股腘动脉支架内再闭塞安全有效。
Objective To assess the efficacy of Rotarex debulking combined with drug-coated balloon(DCB)in the treatment of femoropopliteal artery in-stent occlusion(ISO).Methods Twelve patients with femoropopliteal artery ISO treated with Rotarex debulking combined with DCB were analyzed retrospectively in our hospital from September 2018 to January 2021.Postoperative follow-up was carried out for 3,6 and 12 months with Doppler ultrasound.Results The occlusive length ranged from 80 to 170 mm with(118.58±25.27)mm averagely in the group.Simple superficial femoral artery ISO was in 8 cases,combined with popliteal artery ISO in 4 cases.All 12 cases were completed the intervention successfully without intraoperative arterial rupture perforation,postoperative puncture point complications,cardio-cerebrovascular accidents and death.The post-operative Rutherford grade decreased,and ABI increased from 0.49±0.12 to 0.93±0.10(P<0.05).All cases were followed up for(12.08±3.78)months.Doppler ultrasound showed that 12-month primary patency rate was 84.2%(10/12),and 12-month clinical-driven-free target lesion revascularization rate was 91.7%(11/12).Clinical symptoms appeared again in one case 11th month after the operation,and were relieved by DCB.No mortality and amputation were found during the follow-up period.Conclusion Rotarex debulking combined with DCB could be safe and effective in the treatment of femoropopliteal artery ISO.
作者
李立强
佟铸
崔世军
郭连瑞
LI Li-qiang;TONG Zhu;CUI Shi-jun;GUO Lian-rui(Department of Vascular Surgery, Capital Medical University, Beijing 100053, China)
出处
《中国现代手术学杂志》
2022年第1期25-28,共4页
Chinese Journal of Modern Operative Surgery
