Araki Motoharu, Hirano Keisuke, Nakano Masatsugu, Ito Yoshiaki, Ishimori Hiroshi, Yamawaki Masahiro, Sasaki Shinya, Takimura Hideyuki, Sakamoto Yasunari, Takama Takuro, Tsukahara Reiko, Muramatsu Toshiya
Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, 3-6-1 Shimosueyoshi Tsurumiku, Yokohama City, Kanagawa, 260-0012, Japan,
Cardiovasc Interv Ther. 2014 Jan;29(1):40-6. doi: 10.1007/s12928-013-0210-z. Epub 2013 Sep 26.
To evaluate the 2-year results obtained with self-expandable stent for chronic total occlusion (CTO) of the iliac artery, a retrospective study was performed of patients who underwent endovascular therapy (EVT) for chronic iliac artery CTO who presented from April 2007 to September 2012. 82 patients with 86 occluded iliac arteries underwent successful recanalization and stenting with a self-expandable stent. The primary equivalence end point was a composite of restenosis, mortality, target vessel revascularization, and limb salvage rates. Patients were followed up with the presence of a palpable femoral artery pulse, resolution of symptoms, and noninvasive vascular laboratory testing reviewed at 1, 3, and 6 months after EVT and then were evaluated at 6-month intervals. In patients who gave consent, repeat angiography was done in sixty-one of 86 lesions (70.1 %) for follow-up. The mean follow-up was at 27.6 ± 17.8 months (range 3-60 months). All stents were placed in the true lumen under intravascular ultrasound (IVUS) guidance. There were no cases of peripheral embolization or iliac artery rupture after the procedure. The ankle-brachial index increased significantly from 0.55 ± 0.19 to 0.88 ± 0.17 (P < 0.001). The primary patency rate was 96.5 % at 2 years. The MLD immediately after the procedure was 5.10 ± 0.26 mm and increased significantly to 5.40 ± 0.28 mm at the period of follow-up angiography. The 2-year outcome of endovascular therapy with self-expandable stents for CTO of the iliac artery had an acceptable result.
为评估自膨式支架治疗髂动脉慢性完全闭塞(CTO)的2年效果,我们对2007年4月至2012年9月期间接受血管内治疗(EVT)的髂动脉慢性CTO患者进行了一项回顾性研究。82例患者的86条闭塞髂动脉成功再通并植入自膨式支架。主要等效终点是再狭窄、死亡率、靶血管再血管化和肢体挽救率的综合指标。对患者进行随访,观察股动脉搏动情况、症状缓解情况,并在EVT后1、3和6个月进行无创血管实验室检查,之后每6个月评估一次。在同意的患者中,86个病变中的61个(70.1%)进行了重复血管造影以进行随访。平均随访时间为27.6±17.8个月(范围3 - 60个月)。所有支架均在血管内超声(IVUS)引导下置于真腔内。术后无外周栓塞或髂动脉破裂病例。踝肱指数从0.55±0.19显著增加至0.88±0.17(P<0.001)。2年时的主要通畅率为96.5%。术后即刻的最小管腔直径(MLD)为5.10±0.26mm,在随访血管造影时显著增加至5.40±0.28mm。自膨式支架血管内治疗髂动脉CTO的2年结果令人满意。