Velut J G, Héron E, Emmerich J, Beyssen B, Sapoval M, Lozinguez O, Vandekerckhove C, Gaux J C, Fiessinger J N
Service de médecine vasculaire et centre Claude-Bernard de recherche sur les maladies vasculaires périphériques, Paris, France.
Rev Med Interne. 1999 Apr;20(4):323-8. doi: 10.1016/s0248-8663(99)83071-9.
This retrospective study was aimed at assessing immediate and mid-term results of percutaneous transluminal angioplasty for intermittent claudication in patients over 70 years of age, and the overall morbidity and mortality during follow-up.
Fifty-one percutaneous transluminal angioplasties were performed between 1993 and 1997 in 30 men and eight women (mean age: 78 +/- 5.2; range 71-91) for intermittent claudication (walking distance < 250 m).
Angioplasties were supra-inguinal in 24 cases (47%) and infra-inguinal in 27 cases (53%). Clinical success (walking distance > 500 m) was obtained in 92% of the patients. Significant complications (5.9%) were inguinal hematoma requiring subsequent surgery in one patient and common femoral false aneurysms in two patients. Mean duration of hospitalization was 3 days and a half. After a mean follow-up of 25 months (range: 4-51 months), improvement in the walking distance was still present in 31 patients (82%). The condition of seven (18%) patients did not improve. No patient presented with critical ischemia. As well, no patient underwent surgical revascularization or amputation. However, the condition of eight (21%) patients required subsequent percutaneous transluminal angioplasty. Four (10.5%) patients died. Following percutaneous transluminal angioplasty, six (18%) patients presented with a major non-fatal clinical event. All the patients lived at home.
Percutaneous transluminal angioplasty has little immediate risk when lesions are accessible and leads to positive mid-term clinical results in the treatment of intermittent claudication in patients over 70 years of age.
本回顾性研究旨在评估经皮腔内血管成形术治疗70岁以上间歇性跛行患者的近期和中期结果，以及随访期间的总体发病率和死亡率。
1993年至1997年间，对30名男性和8名女性（平均年龄：78±5.2岁；范围71 - 91岁）进行了51次经皮腔内血管成形术，以治疗间歇性跛行（行走距离<250米）。
血管成形术位于腹股沟上的有24例（47%），腹股沟下的有27例（53%）。92%的患者获得了临床成功（行走距离>500米）。严重并发症（5.9%）包括1例需要后续手术的腹股沟血肿和2例股总动脉假性动脉瘤。平均住院时间为3天半。平均随访25个月（范围：4 - 51个月）后，31例（82%）患者的行走距离仍有改善。7例（18%）患者的病情未改善。没有患者出现严重缺血。此外，没有患者接受手术血运重建或截肢。然而，8例（21%）患者的病情需要后续经皮腔内血管成形术。4例（10.5%）患者死亡。经皮腔内血管成形术后，6例（18%）患者出现重大非致命临床事件。所有患者均在家中生活。
当病变可及且易于操作时，经皮腔内血管成形术的近期风险较小，在治疗70岁以上患者的间歇性跛行方面可取得积极的中期临床效果。
