Gillgren Peter, Pettersson Hans, Fernström Johan, Falkenberg Mårten, Delle Martin, Konrad Peter, Lindström David
Vascular Surgery Section, Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
Ann Vasc Surg. 2011 Aug;25(6):758-65. doi: 10.1016/j.avsg.2010.12.010. Epub 2011 Mar 25.
To assess outcomes in an elderly and diseased population after stenting in the femoropopliteal segment and evaluate risk factors for poor prognosis.
Retrospective study of femoropopliteal stents placed between March 2006 and January 2008. Patency was verified by duplex scanning. Risk factors associated with amputation or death and patency were analyzed using Cox regression.
A total of 117 limbs in 112 patients were observed for a median of 18 months. Median age of the patients was 79 years; 68% were treated for critical limb ischemia and 85% had occlusive lesions. Mean lesion length was 15.4 cm (SD: 9.2) and mean stented length was 19.7 cm (standard deviation: 9.8). At 1 year, primary patency was 63%, primary-assisted patency was 67%, and secondary patency was 69%. Stent diameter ≤6 versus 7 mm was a risk factor for loss of patency with a hazard ratio (HR) of 2.9 (95% CI: 1.1-7.7). Significant risk factors for death or amputation were as follows: HR for rest pain versus claudication was 5.9 (1.1-32.8), HR for tissue loss versus claudication was 5.8 (1.1-29.6), HR for stent diameter ≤6 versus 7 mm was 3.6 (1.0-12.3), and HR for 3-4 stents versus 1-2 was 2.6 (1.1-6.1).
Rutherford status is associated with death or amputation after stenting in the femoropopliteal segment. In addition, a smaller stent diameter and number of stents depict poorer prognosis independent of gender and anatomic level.
评估老年及患病群体在股腘段支架置入术后的结局，并评估预后不良的危险因素。
对2006年3月至2008年1月期间置入的股腘段支架进行回顾性研究。通过双功超声扫描验证通畅情况。使用Cox回归分析与截肢或死亡以及通畅相关的危险因素。
共观察了112例患者的117条肢体，中位观察时间为18个月。患者的中位年龄为79岁；68%的患者因严重肢体缺血接受治疗，85%有闭塞性病变。平均病变长度为15.4 cm（标准差：9.2），平均支架置入长度为19.7 cm（标准差：9.8）。1年时，原发性通畅率为63%，原发性辅助通畅率为67%，继发性通畅率为69%。支架直径≤6 mm与7 mm相比是通畅丧失的危险因素，风险比（HR）为2.9（95%可信区间：1.1 - 7.7）。死亡或截肢的显著危险因素如下：静息痛与间歇性跛行相比的HR为5.9（1.1 - 32.8），组织缺失与间歇性跛行相比的HR为5.8（1.1 - 29.6），支架直径≤6 mm与7 mm相比的HR为3.6（1.0 - 12.3），3 - 4个支架与1 - 2个支架相比的HR为2.6（1.1 - 6.1）。
Rutherford分级与股腘段支架置入术后的死亡或截肢相关。此外，较小的支架直径和支架数量表明预后较差，与性别和解剖水平无关。
