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球囊扩张式腔内支架在髂动脉中的置入:首例171例手术

Placement of balloon-expandable intraluminal stents in iliac arteries: first 171 procedures.

作者信息

Palmaz J C, Garcia O J, Schatz R A, Rees C R, Roeren T, Richter G M, Noeldge G, Gardiner G A, Becker G J, Walker C

机构信息

Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800.

出版信息

Radiology. 1990 Mar;174(3 Pt 2):969-75. doi: 10.1148/radiology.174.3.174-3-969.

Abstract

Balloon-expandable intraluminal stents were used to treat iliac artery stenoses or occlusions that failed to respond to conventional balloon angioplasty. One hundred seventy-one procedures were performed in 154 patients, of whom 48 had a limb at risk for amputation. Thirty-six had severe and 70 had moderate intermittent claudication. At the latest follow-up examination (average, 6 months; range, 1-24 months), 137 patients demonstrated clinical benefit, 113 of whom had become asymptomatic. Eleven patients showed no initial benefit, and six improved initially but later developed new vascular symptoms. Complications occurred in 18 patients. In three patients, complications were directly related to the device. Two occlusions were successfully recanalized, and an intramural collection of contrast material secondary to balloon perforation evolved favorably. The remaining patients had groin hematoma (n = 6), distal embolization (n = 4), extravasation (n = 2), transient renal failure (n = 1), pseudoaneurysm at the puncture site (n = 1), or subintimal dissection (n = 1). All stents have remained patent to the latest follow-up examination without evidence of migration or aneurysm formation.

摘要

球囊扩张式腔内支架用于治疗对传统球囊血管成形术无反应的髂动脉狭窄或闭塞。对154例患者实施了171例手术,其中48例患者的肢体有截肢风险。36例有严重间歇性跛行,70例有中度间歇性跛行。在最近的随访检查中(平均6个月;范围1 - 24个月),137例患者显示出临床获益,其中113例已无症状。11例患者最初未显示获益,6例最初有改善但后来出现了新的血管症状。18例患者出现并发症。3例患者的并发症与器械直接相关。成功再通了2例闭塞,球囊穿孔继发的壁内造影剂聚集好转。其余患者有腹股沟血肿(n = 6)、远端栓塞(n = 4)、外渗(n = 2)、短暂性肾衰竭(n = 1)、穿刺部位假性动脉瘤(n = 1)或内膜下夹层(n = 1)。至最近一次随访检查时,所有支架均保持通畅,无移位或动脉瘤形成的迹象。

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