May Kyin Kyin, Robless Peter Ashley, Sidhu Harvinder Raj Singh, Chua Ben Soo Yeng, Ho Pei
1Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Vasc Endovascular Surg. 2014 Feb;48(2):129-33. doi: 10.1177/1538574413512377. Epub 2013 Nov 20.
This study aims to review the outcome of patients with peripheral arterial disease (PAD) managed with endovascular first approach for revascularization in a tertiary referral center. Revascularization procedures were performed in 202 patients with 229 symptomatic limbs. Angiogram was performed in all patients except those contraindicated for contrast agent. Angioplasty revascularization was carried out on the same setting whenever feasible based on the angiogram findings. Bypass surgery was performed in patients with arterial condition not feasible for endovascular intervention or in those with unsatisfactory revascularization after endovascular treatment. Endovascular intervention was successfully performed in 198 limbs. Bypass surgery was required in 31 patients. Another 16 patients required a bypass after endovascular intervention due to unsatisfactory wound healing. The Kaplan-Meier estimated survival and amputation-free survival were 80% and 75.5% at 1 year and 73% and 57.6% at 2 years, respectively. Satisfactory limb salvage rate can be achieved in patients with PAD managed with endovascular first approach.
本研究旨在回顾在一家三级转诊中心采用血管腔内优先入路进行血运重建治疗的外周动脉疾病（PAD）患者的治疗结果。对202例患者的229条有症状肢体进行了血运重建手术。除了那些有造影剂禁忌的患者外，所有患者均进行了血管造影。根据血管造影结果，只要可行，就在同一环境下进行血管成形术血运重建。对于动脉状况不适合进行血管腔内干预的患者或血管腔内治疗后血运重建效果不理想的患者，进行了旁路手术。198条肢体成功进行了血管腔内干预。31例患者需要进行旁路手术。另外16例患者在血管腔内干预后因伤口愈合不理想而需要进行旁路手术。Kaplan-Meier估计的1年生存率和无截肢生存率分别为80%和75.5%，2年时分别为73%和57.6%。采用血管腔内优先入路治疗的PAD患者可实现令人满意的肢体挽救率。
