Liang Gang-zhu, Zhang Fu-xian, Luo Xiao-yun, Zhang Chang-ming, Hu Lu, Feng Ya-ping, Niu Lu-yuan, Zhang Huan, Ma Bing-bing, Qi Hao-shan, Guo Mei-mei, Long Yan-Yu, Li Hai-Lei
Department of Vascular Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital, China.
Zhonghua Wai Ke Za Zhi. 2012 Aug;50(8):704-8.
Using two antithrombotic treatment (clopidogrel vs. clopidogrel combined warfarin) strategies after femoral-popliteal artery angioplasty prospectively, to evaluate which strategy is more effective for the restenosis prevention.
Totally 50 patients referred for endovascular treatment (including the percutaneous transluminal angioplasty (PTA) and stent implantation) of the superficial femoral artery and popliteal artery from January 2008 to May 2009 were randomly divided into clopidogrel group (group A, 25 cases, 30 limbs) and clopidogrel plus warfarin group (group B, 25 cases, 33 limbs) before operation. Clinical outcomes and restenosis rate of the target lesions were evaluated at 3, 6 and 12 months after operation.
Totally 88 patients were screened for participation in the study, 56 patients were included after the follow-up of 12 months. At 3 months, the rates of restenosis were 16.7% in group A and 18.2% in group B (χ² = 0.025, P = 0.874). At 6 months, the accumulated restenosis rates were 36.7% in group A and 36.4% in group B (χ² = 0.001, P = 0.98). At 12 months, the accumulated restenosis rates were 53.3% in group A and 42.4% in group B (χ² = 0.75, P = 0.387). Analysis for the critical limb ischemia sub-group showed that follow-up of 12 months, the accumulated restenosis rate was 8/10 in group A and 6/12 in group B (χ² = 1.023, P = 0.312).
The clopidogrel alone treatment for PTA or PTA plus stent implantation of femoral popliteal artery has no statistically significant difference in comparison with the clopidogrel combined warfarin treatment in terms of the cumulative vascular restenosis rate at 3, 6, 12 months postoperatively.
前瞻性地采用两种抗栓治疗策略（氯吡格雷对比氯吡格雷联合华法林）用于股腘动脉血管成形术后，评估哪种策略在预防再狭窄方面更有效。
2008年1月至2009年5月期间，共50例因股浅动脉和腘动脉接受血管内治疗（包括经皮腔内血管成形术（PTA）和支架植入）的患者在术前被随机分为氯吡格雷组（A组，25例，30条肢体）和氯吡格雷加华法林组（B组，25例，33条肢体）。在术后3、6和12个月评估目标病变的临床结局和再狭窄率。
共88例患者被筛选参与本研究，12个月随访后纳入56例患者。3个月时，A组再狭窄率为16.7%，B组为18.2%（χ² = 0.025，P = 0.874）。6个月时，A组累积再狭窄率为36.7%，B组为36.4%（χ² = 0.001，P = 0.98）。12个月时，A组累积再狭窄率为53.3%，B组为42.4%（χ² = 0.75，P = 0.387）。对严重肢体缺血亚组的分析显示，随访12个月时，A组累积再狭窄率为8/10，B组为6/12（χ² = 1.023，P = 0.312）。
在术后3、6、12个月时，单纯氯吡格雷治疗用于股腘动脉PTA或PTA加支架植入与氯吡格雷联合华法林治疗相比，在累积血管再狭窄率方面无统计学显著差异。
