摘要
目的探讨联合腔内支架植入和旁路转流术治疗下肢多平面动脉闭塞症的初步临床经验。方法1998年11月～2002年12月,14例病人(20条肢体)多平面动脉硬化闭塞症病人同时进行髂动脉支架植入(16条肢体)和远端动脉旁路转流术(20条肢体)。结果16条肢体中14例髂动脉支架植入成功。远端动脉旁路转流术包括膝上6条,膝下14条。20条肢体术前平均踝肱指数为0.32±9.40,术后为0.77±7.30,二者相比有显著差异(P<0.01)。平均随访24(3～49)个月,髂动脉支架一期通畅率为92.8%(13/14),二期通畅率为100%(14/14);远端动脉旁路转流手术一期通畅率为85%(17/20),二期通畅率为95%(19/20)。全组无手术死亡。结论支架植入联合旁路转流治疗下肢多平面动脉闭塞症,技术安全,初步结果满意,长期结果有待进一步随访。
Objective To review our preliminary experience of a combined stent placement and bypass reconstruction procedure for the treatment of multilevel arterial occlusive diseases of the lower extremities. Methods From November 1998 to December 2002, iliac arterial stent placement combined with infrainguinal bypass reconstruction were performed on 20 lower limbs of 14 patients. Results Fourteen cases of iliac stent placement were successful in 16 affected limbs. Combined by pass procedures were porformed immediately afterwards and included 6 procedures above the knee and 14 below the knee. The mean pre-operative and post-operative ankle brachial index of 20 limbs were 0.32±9.4 and 0.77±7.3 respectively (P<0.01). Mean follow-up time was 24 months (range 3～49 months). The primary and secondary patency rate of the stented iliac arteries were 92.8%(13/14)and 100%(14/14),respectively. The primary and secondary patency rate were 85%(17/20) and 95%(19/20), respectively for the bypass procedures. There was no postoperative morbidity or mortality. Conclusions Stent placement in combination with infrainguinal bypass procedures are technically feasible and potentially preferable for the treatment of multilevel arterial occlusive diseases of the lower extremities. Long-term follow-up will be necessary for further assessment.
出处
《外科理论与实践》
2004年第2期140-142,155,共4页
Journal of Surgery Concepts & Practice
