Kang Won Yu, Campia Umberto, Ota Hideaki, Didier Romain J, Negi Smita I, Kiramijyan Sarkis, Koifman Edward, Baker Nevin C, Magalhaes Marco A, Lipinski Michael J, Escarcega Ricardo O, Torguson Rebecca, Waksman Ron, Bernardo Nelson L
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States.
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States.
Cardiovasc Revasc Med. 2016 Apr-May;17(3):190-8. doi: 10.1016/j.carrev.2016.02.001. Epub 2016 Feb 8.
Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each.
目前，经皮血管腔内介入治疗被认为是治疗严重肢体缺血患者的一线疗法。由于技术和工艺的显著发展，经皮血管腔内介入治疗已使肢体挽救率与旁路手术相当，并发症更少，即使长期通畅率较低。目前，介入医生有多种入路途径，包括较小的动脉，有顺行和逆行两种方法。因此，选择最佳入路部位已成为经皮介入治疗成功的一个组成部分。通过了解每种方法的技术方面以及优缺点，介入医生可以改善严重外周动脉疾病患者的临床结局。本文综述了严重肢体缺血的入路途径、其优缺点以及每种途径的临床结局。
