Baumann Frederic, Fust Jacqueline, Engelberger Rolf Peter, Hügel Ulrike, Do Do-Dai, Willenberg Torsten, Baumgartner Iris, Diehm Nicolas
1 Department of Clinical and Interventional Angiology, Swiss Cardiovascular Center, and.
J Endovasc Ther. 2014 Feb;21(1):44-51. doi: 10.1583/13-4486MR.1.
To assess the extent of early recoil in patients with critical limb ischemia (CLI) undergoing conventional tibial balloon angioplasty.
Our hypothesis was that early recoil, defined as lumen compromise >10%, is frequent and accounts for considerable luminal narrowing after tibial angioplasty, promoting restenosis. To test this theory, 30 consecutive CLI patients (18 men; mean age 76.2±12.1 years) were angiographically evaluated immediately after tibial balloon angioplasty and 15 minutes later. Half the patients were diabetics. Target lesions included anterior and posterior tibial arteries and the peroneal artery with / without the tibioperoneal trunk. Mean tibial lesion length was 83.8 mm. Early elastic recoil was determined on the basis of minimal lumen diameter (MLD) measurements at baseline (MLDbaseline), immediately after tibial balloon angioplasty (MLDpostdilation), and 15 minutes thereafter (MLD15min).
Elastic recoil was observed in 29 (97%) patients with a mean luminal compromise of 29% according to MLD measurements (MLDbaseline 0.23 mm, MLD postdilation 2.0 mm, and MLD15min 1.47 mm).
Early recoil is frequently observed in CLI patients undergoing tibial angioplasty and may significantly contribute to restenosis. These findings support the role of dedicated mechanical scaffolding approaches for the prevention of restenosis in tibial arteries.
评估接受传统胫动脉球囊血管成形术的严重下肢缺血（CLI）患者早期回缩的程度。
我们的假设是，早期回缩（定义为管腔狭窄>10%）很常见，并且是胫动脉血管成形术后管腔显著狭窄的原因，会促进再狭窄。为了验证这一理论，对30例连续的CLI患者（18例男性；平均年龄76.2±12.1岁）在胫动脉球囊血管成形术后立即及15分钟后进行血管造影评估。一半患者为糖尿病患者。靶病变包括胫前动脉、胫后动脉和腓动脉，伴或不伴有胫腓干。胫动脉平均病变长度为83.8毫米。早期弹性回缩根据基线时的最小管腔直径（MLD基线）、胫动脉球囊血管成形术后立即（MLD扩张后）以及此后15分钟（MLD15分钟）的测量值来确定。
根据MLD测量，29例（97%）患者出现弹性回缩，平均管腔狭窄29%（MLD基线0.23毫米，MLD扩张后2.0毫米，MLD15分钟1.47毫米）。
在接受胫动脉血管成形术的CLI患者中经常观察到早期回缩，并且可能显著促成再狭窄。这些发现支持了采用专门的机械支架置入方法预防胫动脉再狭窄的作用。
