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[施特雷克血管假体。中期和长期结果]

[Strecker vascular prostheses. The median- and long-term results].

作者信息

Lupattelli L, Barzi F, Mosca S, Maselli A, Pozzilli P

机构信息

Istituto di Radiologia, Università degli Studi, Perugia.

出版信息

Radiol Med. 1992 Nov;84(5):602-7.

PMID:1475424
Abstract

Between September 1989 and October 1991, 37 patients were treated with percutaneous transluminal angioplasty (PTA) and the insertion of a Strecker stent. The patients--35 men and 2 women, mean age 61 years, range 41-47--had 39 lesions in 39 arteries--30 iliac arteries, 8 femoral arteries and 1 popliteal artery. The lesions included 19 dissections after PTA (48%), 13 residual stenoses > 30% after PTA (34%), 7 restenoses (18%) and 4 total occlusions (10%). The stents were successfully inserted in 37/39 cases (95%). Complications occurred in 4 patients: 2 acute thromboses (resolved with local infusion of urokinase), 1 distal embolization and 1 pseudoaneurysm. Distal embolization, despite aspiration and local fibrinolysis, required leg amputation after about 1 month. The max follow-up period was 2 years (average 15 months): patency was 97% at 1 and 3 months, 100% at 6 and 12 months, 95% at 18 months and 100% at 24 months. Total patency was 85% at 24 months. Four patients were lost to follow-up, and 1 patient died. Four stents failed: 2 of them at 1 and 3 months, and surgery was performed, and 2 at 18 months. Intimal hyperplasia of minimum grade occurred in 2 vessels. There was no evidence of stent migration. The authors believe that the placement of Strecker stents is a valuable approach to the treatment of PTA complications.

摘要

1989年9月至1991年10月期间,37例患者接受了经皮腔内血管成形术(PTA)并植入了施特雷克支架。患者包括35名男性和2名女性,平均年龄61岁,年龄范围为41 - 47岁,39条动脉中有39处病变,其中30处为髂动脉病变,8处为股动脉病变,1处为腘动脉病变。病变包括PTA术后19处夹层(48%)、PTA术后13处残余狭窄>30%(34%)、7处再狭窄(18%)和4处完全闭塞(10%)。39例中有37例(95%)成功植入支架。4例患者出现并发症:2例急性血栓形成(经局部输注尿激酶后缓解)、1例远端栓塞和1例假性动脉瘤。尽管进行了抽吸和局部纤维蛋白溶解治疗,远端栓塞仍在约1个月后需要截肢。最大随访期为2年(平均15个月):1个月和3个月时通畅率为97%,6个月和12个月时为100%,18个月时为95%,24个月时为100%。24个月时总通畅率为85%。4例患者失访,1例患者死亡。4个支架失败:其中2个在1个月和3个月时失败,随后进行了手术,另外2个在18个月时失败。2条血管出现最低级别的内膜增生。没有支架移位的证据。作者认为,植入施特雷克支架是治疗PTA并发症的一种有价值的方法。

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