Evans C, Peter N, Gibson M, Torrie E Ph, Galland R B, Magee T R
Department of General Surgery, Royal Berkshire Hospital, Reading, UK.
Ann R Coll Surg Engl. 2010 May;92(4):347-52. doi: 10.1308/003588410X12664192075099.
Retrograde transpopliteal angioplasty (PA) is a potentially useful alternative technique for endovascular treatment of infra-inguinal arterial disease when antegrade transfemoral puncture (FA) is technically not possible or appropriate. This study aimed to investigate the outcomes of PA compared with FA during a 5-year period.
A retrospective study was performed to assess 88 PA and 275 FA performed between January 2003 and January 2008. Assessments of patients, indication for procedure, disease site, stenosis severity, procedure outcomes and time to further intervention were recorded.
FA was used to treat more patients with critical ischaemia (42.2% vs 30.7%; P = 0.014)). PA was used to treat more proximal superficial femoral lesions (P < 0.001) and occlusive lesions (P = 0.001). Overall, 84.1% of PA and 82.5 % of FA were technically successful. There was no difference in local puncture site complication rates. Significantly more FA resulted in distal thrombus/embolism (8.4% vs 3.4%; P = 0.044). Further intervention was required in 27.3% of PA and 36.0% of FA. The time interval to re-intervention was not different between the groups.
PA is safe with comparable success rates and long-term outcomes to an FA. PA is a useful alternative approach for treating occlusive, proximal disease.
当顺行股动脉穿刺（FA）在技术上不可行或不合适时，逆行腘动脉血管成形术（PA）是治疗股腘动脉疾病的一种潜在有用的替代技术。本研究旨在调查5年期间PA与FA的治疗效果。
进行一项回顾性研究，评估2003年1月至2008年1月期间进行的88例PA和275例FA。记录患者评估、手术指征、疾病部位、狭窄严重程度、手术结果和进一步干预时间。
FA用于治疗更多严重缺血患者（42.2%对30.7%；P = 0.014）。PA用于治疗更多股浅动脉近端病变（P < 0.001）和闭塞性病变（P = 0.001）。总体而言，84.1%的PA和82.5%的FA在技术上成功。局部穿刺部位并发症发生率无差异。显著更多的FA导致远端血栓/栓塞（8.4%对3.4%；P = 0.044）。27.3%的PA和36.0%的FA需要进一步干预。两组之间再次干预的时间间隔无差异。
PA是安全的，成功率和长期结果与FA相当。PA是治疗闭塞性近端疾病的一种有用的替代方法。
