Nasr M K, McCarthy R J, Hardman J, Chalmers A, Horrocks M
Royal United Hospital, Combe Park, Bath BA1 3NG, U.K.
Eur J Vasc Endovasc Surg. 2002 May;23(5):398-403. doi: 10.1053/ejvs.2002.1615.
to review the current role and results of angioplasty in the management of critical limb ischaemia (CLI) in a single institution.
data on 526 patients with 608 ischaemic limbs, treated between January 1994 and December 1999 was collected prospectively and analysed retrospectively. Patients were divided into 3 groups according to the date of presentation: group 1 (1994-95), group 2 (1996-97) and group 3 (1998-99). The groups were comparable in terms of demographics, mode of presentation and level of disease.
Revascularisation was attempted in 87%, 81% and 91% for groups 1, 2 and 3 respectively (NS). Primary percutaneous transluminal angioplasty (PTA) rates increased from 44% (1994-95) to 69% (1998-99) (p < 0.001), and surgical revascularisation rates decreased correspondingly (p<0.01). Overall cumulative patient survival and limb salvage rates were 82% and 89% for 1 year and 45% and 87% for 5 years, respectively. No statistically significant difference existed between the three groups regarding patient survival, limb salvage rates and mean hospital stay (19, 12 and 12 days, respectively).
PTA is increasingly replacing bypass surgery in the treatment of CLI, without compromising patient survival or limb salvage rates.
回顾在单一机构中血管成形术在严重肢体缺血（CLI）治疗中的当前作用及结果。
前瞻性收集并回顾性分析1994年1月至1999年12月间526例患者608条缺血肢体的数据。根据就诊日期将患者分为3组：第1组（1994 - 95年）、第2组（1996 - 97年）和第3组（1998 - 99年）。各组在人口统计学、就诊方式和疾病程度方面具有可比性。
第1组、第2组和第3组分别有87%、81%和91%的患者尝试了血运重建（无统计学差异）。初次经皮腔内血管成形术（PTA）的比例从44%（1994 - 95年）增至69%（1998 - 99年）（p < 0.001），手术血运重建率相应下降（p < 0.01）。总体累积患者生存率和肢体挽救率1年时分别为82%和89%，5年时分别为45%和87%。三组在患者生存率、肢体挽救率和平均住院天数（分别为19天、12天和12天）方面无统计学显著差异。
在CLI治疗中，PTA正越来越多地取代旁路手术，且不影响患者生存率或肢体挽救率。
