Johnston K W
Division of Vascular Surgery, University of Toronto, Ontario, Canada.
Surg Clin North Am. 1992 Aug;72(4):843-50. doi: 10.1016/s0039-6109(16)45780-4.
In the past, patients with peripheral arterial occlusive disease were managed by conservative treatment or by vascular reconstructive surgery. Now, percutaneous transluminal angioplasty and other endovascular methods provide an important alternative for managing selected patients with peripheral arterial occlusive disease. Overall, the 5-year success rate after iliac angioplasty is 53.4%, but the success rate is higher if percutaneous transluminal angioplasty is performed on the common iliac artery or on a stenosed artery. In contrast, percutaneous transluminal angioplasty of the femoral and popliteal arteries has a relatively poor long-term success rate except for the treatment of patients with stenoses with good run-off. When the run-off is poor or an arterial occlusion is present, the role of femoropopliteal angioplasty is limited, and the procedure should be considered only for high-risk patients who do not have autogenous tissue for reconstructive surgery.
过去,外周动脉闭塞性疾病患者通过保守治疗或血管重建手术进行处理。如今,经皮腔内血管成形术及其他血管内治疗方法为部分外周动脉闭塞性疾病患者的治疗提供了重要的替代方案。总体而言,髂动脉血管成形术后的5年成功率为53.4%,但如果对髂总动脉或狭窄动脉进行经皮腔内血管成形术,成功率会更高。相比之下,除了对流出道良好的狭窄患者进行治疗外,股动脉和腘动脉的经皮腔内血管成形术长期成功率相对较低。当流出道不佳或存在动脉闭塞时,股腘动脉血管成形术的作用有限,该手术仅应考虑用于没有自体组织进行重建手术的高危患者。