Dept. for Radiology and Nuclear medicine, Catholic Clinic Mainz, An der Goldgrube 11, 55131 Mainz, Germany.
Eur J Radiol. 2010 Jul;75(1):48-56. doi: 10.1016/j.ejrad.2010.04.016. Epub 2010 May 7.
Evaluation of percutaneous recanalization of obstructed iliac as well as superficial femoral arteries (SFAs) in patients with peripheral arterial obstructive disease (PAOD).
The data of 195 consecutive patients with 285 obstructions of the common and or external iliac artery as well as the data of 452 consecutive patients with 602 long occlusions (length>5 cm) of the SFA were retrospectively analyzed. The lesions were either treated with percutaneous transluminal angioplasty (PTA) or Excimer laser assisted percutaneous transluminal angioplasty (LPTA). Overall 316 stents were implanted (Nitinol stents: 136; stainless steel stents: 180) in the iliac artery and 669 stents were implanted (Nitinol stents: 311; Easy Wallstents: 358) in the SFA. The follow-up period was 36-65 months (mean 46.98+/-7.11 months) postinterventionally using clinical examination, ABI calculation, and color-coded duplex sonography. Patency rates were calculated on the basis of the Kaplan-Meier analysis.
The overall primary technical success rate was 97.89% for the iliac arteries and 92.35% for the SFA. Minor complications (hematoma, distal emboli and vessel dissection) were documented in 11.79% for the iliac arteries and 7.97% for the SFA. The primary patency rate was 90.3% for the iliac and 52.8% for the SFA after 4 years. The secondary patency rate was 96.84% for the iliac and 77.8% for the SFA after 4 years.
Percutaneous recanalization of iliac and superficial femoral artery obstructions is a safe and effective technique for the treatment of patients with PAOD. By consequent clinical monitoring high secondary patency rates can be achieved. The use of a stents seems to result in higher patency rate especially in the SFA when compared to the literature in long-term follow-up.
评估经皮腔内血管成形术（PTA）治疗外周动脉阻塞性疾病（PAOD）患者髂动脉及股浅动脉（SFA）阻塞的效果。
回顾性分析了 195 例 285 处髂总动脉和（或）髂外动脉狭窄、452 例 602 处股浅动脉长段闭塞（长度＞5cm）患者的资料，病变采用 PTA 或准分子激光辅助 PTA（LPTA）治疗。髂动脉共植入 316 枚支架（Nitinol 支架 136 枚，不锈钢支架 180 枚），股浅动脉共植入 669 枚支架（Nitinol 支架 311 枚，Easy Wallstents 358 枚）。术后通过临床检查、ABI 计算和彩色多普勒超声进行随访，随访时间为 36-65 个月（平均 46.98±7.11 个月）。采用 Kaplan-Meier 分析计算通畅率。
髂动脉和股浅动脉的初始技术成功率分别为 97.89%和 92.35%。髂动脉并发症发生率为 11.79%（血肿、远端栓塞和血管夹层），股浅动脉为 7.97%。术后 4 年髂动脉和股浅动脉的初始通畅率分别为 90.3%和 52.8%，次级通畅率分别为 96.84%和 77.8%。
经皮腔内血管成形术治疗 PAOD 患者髂动脉及股浅动脉阻塞是一种安全有效的方法，通过持续的临床监测可以获得较高的次级通畅率。与文献报道的长期随访结果相比，支架的使用似乎可以提高通畅率，尤其是在股浅动脉。
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