Martin D R, Katz S G, Kohl R D, Qian D
Department of Surgery, Huntington Memorial Hospital, Pasadena, CA, USA.
Ann Vasc Surg. 1999 Mar;13(2):184-7. doi: 10.1007/s100169900239.
In the last decade, percutaneous angioplasty (PTA) has been used with increasing frequency to treat infrainguinal atherosclerotic lesions. In hopes of better delineating the role of PTA, we undertook a retrospective analysis of infrainguinal PTA in one hospital over a 7-year period. The charts of all patients receiving infrainguinal PTA from 1989 to 1996 were reviewed. Demographics, site and type of lesion, and results of treatment were recorded. Survival curves were plotted using the Kaplan-Meier method following current Society of Vascular Surgery/International Society for Cardiovascular Surgery (SVS/ISCVS) guidelines. Differences in times to first failure were tested using the log rank method. Failures were documented by duplex ultrasound. All patients requiring repeat intervention underwent contrast angiography. In selected patients with stenotic lesions <3 cm, infrainguinal PTA may be an appropriate initial treatment modality. However, 5-year patency rates are significantly lower than those achieved by saphenous vein grafting. The efficacy of the procedure is markedly decreased when used to treat arterial stenoses >3 cm in length as well as occlusions, and surgical revascularization may be a more appropriate initial therapeutic procedure.
在过去十年中，经皮血管成形术（PTA）治疗腹股沟下动脉粥样硬化病变的应用频率不断增加。为了更好地界定PTA的作用，我们对一家医院7年间腹股沟下PTA进行了回顾性分析。回顾了1989年至1996年期间所有接受腹股沟下PTA治疗患者的病历。记录了患者的人口统计学资料、病变部位和类型以及治疗结果。按照血管外科学会/国际心血管外科学会（SVS/ISCVS）现行指南，采用Kaplan-Meier法绘制生存曲线。使用对数秩检验法检验首次失败时间的差异。通过双功超声记录失败情况。所有需要再次干预的患者均接受了造影血管造影。对于病变长度<3 cm的狭窄性病变患者，腹股沟下PTA可能是一种合适的初始治疗方式。然而，其5年通畅率显著低于隐静脉移植术。当用于治疗长度>3 cm的动脉狭窄以及闭塞时，该手术的疗效明显降低，手术血运重建可能是更合适的初始治疗方法。
