Horvath W, Oertl M, Haidinger D
Department of Radiology, Krankenhaus der Barmherzigen Brueder, Linz, Austria.
Radiology. 1990 Nov;177(2):565-9. doi: 10.1148/radiology.177.2.2145609.
The authors dilated 103 stenosed crural arteries in 71 patients. Primary success was defined as traversing and reducing the lesion to a residual stenosis of less than 30%. This was achieved in 96% of cases. Complications included one vessel rupture and one occluding intimal flap, which were treated by the vascular surgeon with bypass and venous patch, respectively. One hematoma at the puncture site was treated surgically because of its size. With modern materials such as steerable guide wires and low-profile balloon catheters, dilation of crural arteries has become safe. Until now, the indications for percutaneous transluminal angioplasty (PTA) of crural arteries have been limited to Fontaine stages III and IV disease. The authors believe that the indications for PTA in Fontaine stage IIb disease are justified, especially if intervention improves outflow after a more proximal recanalizing procedure is performed.
作者对71例患者的103条狭窄的小腿动脉进行了扩张。初步成功定义为穿过病变并将其缩小至残余狭窄小于30%。96%的病例达到了这一目标。并发症包括1例血管破裂和1例阻塞性内膜瓣，分别由血管外科医生采用搭桥术和静脉补片进行治疗。1例穿刺部位血肿因体积较大而接受了手术治疗。使用可操纵导丝和低轮廓球囊导管等现代材料后，小腿动脉扩张已变得安全。到目前为止，小腿动脉经皮腔内血管成形术（PTA）的适应证仅限于Fontaine III期和IV期疾病。作者认为，Fontaine IIb期疾病行PTA的适应证是合理的，特别是如果在进行更近端的再通手术后干预能改善流出道的话。
