Gisbertz Suzanne S, de Borst Gert-Jan, Overtoom Tim Th C, Moll Frans L, de Vries Jean-Paul P M
Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, Netherlands.
Vasc Endovascular Surg. 2010 Jan;44(1):20-4. doi: 10.1177/1538574409347397. Epub 2009 Oct 14.
Remote endarterectomy is a less invasive technique compared with supragenicular bypass surgery for superficial femoral artery (SFA) occlusive disease. Early restenosis remains one of the drawbacks of this procedure. To prevent restenosis following remote endarterectomy, concomitant cryoplasty of the desobstruct SFA was introduced.
A prospective cohort study was initiated with 17 patients treated with cryoplasty of the SFA after remote endarterectomy. Indications for surgery were claudication (n = 12), rest pain (n = 3), or tissue loss (n = 2).
There were no technical failures. The Kaplan-Meier estimate of the primary and assisted primary patency rate after 1 year of follow-up was 74%. Secondary patency was 89%. Limb salvage was 100%. No aneurysmal degeneration and no other adverse events occurred during the follow-up.
This pilot study showed that cryoplasty after remote SFA endarterectomy is a safe procedure, with promising patency rates.
与膝上股浅动脉（SFA）闭塞性疾病的旁路手术相比，远端动脉内膜切除术是一种侵入性较小的技术。早期再狭窄仍然是该手术的缺点之一。为防止远端动脉内膜切除术后再狭窄，引入了对通畅的SFA进行同期冷冻球囊血管成形术。
开展一项前瞻性队列研究，纳入17例在远端动脉内膜切除术后接受SFA冷冻球囊血管成形术治疗的患者。手术指征为间歇性跛行（n = 12）、静息痛（n = 3）或组织缺损（n = 2）。
无技术失败情况。随访1年后，采用Kaplan-Meier法估计的一期通畅率和辅助一期通畅率为74%。二期通畅率为89%。肢体挽救率为100%。随访期间未发生动脉瘤样退变及其他不良事件。
这项初步研究表明，远端SFA动脉内膜切除术后的冷冻球囊血管成形术是一种安全的手术，通畅率前景良好。
