Greiner A, Dessl A, Klein-Weigel P, Neuhauser B, Perkmann R, Waldenberger P, Jaschke W, Fraedrich G
Department of Vascular Surgery, University Hospital, Leopold Franzens University, Anichstrasse 35, A-6020 Innsbruck, Austria.
Eur J Vasc Endovasc Surg. 2003 Aug;26(2):161-5. doi: 10.1053/ejvs.2002.1882.
to determine medium term technical and clinical success of kissing stents for aortoiliac occlusive disease.
retrospective study.
twenty-five patients presenting with intermittent claudication (IC) or critical limb ischaemia (CLI) due to aortoiliac disease (41 complex stenoses, 8 occlusions).
balloon- or self-expanding kissing stents, with or without predilatation depending upon the nature of the disease, were inserted via bilateral retrograde femoral artery punctures. Clinical examination, ABPI, exercise testing and duplex ultrasound were performed at 1, 3, 6, and 12 months, and then annually.
technical success was achieved in 86% segments. All patients with CLI improved and 6 of 7 ulcerated limbs showed complete healing. During follow-up, 7 patients died and two patients required major amputation at 7 and 8 months. The primary assisted patency rate was 94, 91 and 65% at 6, 12, and 24 months, respectively.
despite acceptable short-term technical and clinical success, as the medium term patency rates are clearly inferior to those of bypass surgery, the kissing stent technique should be reserved for high risk patients with a limited life expectancy.
确定用于主髂动脉闭塞性疾病的吻合支架的中期技术成功率和临床成功率。
回顾性研究。
25例因主髂动脉疾病出现间歇性跛行（IC）或严重肢体缺血（CLI）的患者（41处复杂性狭窄，8处闭塞）。
根据疾病性质，通过双侧逆行股动脉穿刺插入球囊扩张式或自膨胀式吻合支架，部分病例进行预扩张。在1、3、6和12个月时进行临床检查、踝肱指数（ABPI）、运动试验和双功超声检查，之后每年进行一次。
86%的节段获得技术成功。所有CLI患者病情均有改善，7例溃疡肢体中有6例完全愈合。随访期间，7例患者死亡，2例患者分别在7个月和8个月时需要进行大截肢。6个月、12个月和24个月时的主要辅助通畅率分别为94%、91%和65%。
尽管短期技术成功率和临床成功率尚可，但由于中期通畅率明显低于旁路手术，吻合支架技术应仅用于预期寿命有限的高危患者。
