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使用紫杉醇涂层球囊对股浅动脉进行血管重建治疗间歇性跛行。

Revascularization of the superficial femoral artery with paclitaxel-coated balloon for claudication.

作者信息

Deloge Celine, Boesmans Evelyne, Van Damme Hendrik, Defraigne Jean-Olivier

机构信息

a Dpt Cardiovascular Surgery , University Hospital Sart Tilman , Liège , Belgium.

出版信息

Acta Chir Belg. 2018 Feb;118(1):42-47. doi: 10.1080/00015458.2017.1374593. Epub 2017 Sep 11.

Abstract

BACKGROUND

Percutaneous angioplasty of the superficial femoral artery (SFA) with paclitaxel-coated balloon, intended to reduce restenosis, has been proven safe and effective in recent randomized controlled trials.

OBJECTIVE

To assess outcome results of angioplasty of the SFA with paclitaxel-coated balloon in claudicants in real-world practice of a single center.

MATERIAL & METHODS: A continuous prospective cohort study of 53 claudicants (62 lower limbs) from January 2015 to December 2016. Study end points include primary patency, freedom from clinically driven target-lesion revascularization and symptom relief.

RESULTS

It concerns 17 women (32%) and 36 men (68%) with a mean age of 67.8 years, suffering life-style-limiting claudication. Only short to intermediate-length stenoses or occlusions (30.6%), with a mean length of 59.6 mm were selected for percutaneous angioplasty with a paclitaxel-coated balloon. Technical success was 100%. At 16 months, primary patency attained 92.0% (3 early occlusions, 2 restenoses). There were two re-interventions at 6 and 9 months, resulting in a clinically driven target lesion revascularization rate of 3.2%. At the end of the follow-up of 16 months, all but two patients (96.2%) remained symptom-free. Two patients died during follow-up (no procedure-related deaths).

CONCLUSION

Paclitaxel-coated balloon angioplasty of the SFA gives in routine clinical practice excellent midterm results, with a restenosis rate of 6.5% at 1 year. This procedure has authors' preference as first-choice technique for correction of short- and intermediate-length symptomatic stenoses of the SFA.

摘要

背景

在近期的随机对照试验中,已证实使用紫杉醇涂层球囊对股浅动脉(SFA)进行经皮血管成形术可降低再狭窄率,且安全有效。

目的

评估在单中心的实际临床实践中,使用紫杉醇涂层球囊对间歇性跛行患者的SFA进行血管成形术的结果。

材料与方法

对2015年1月至2016年12月期间的53例间歇性跛行患者(62条下肢)进行连续前瞻性队列研究。研究终点包括初始通畅率、免于临床驱动的靶病变血管重建以及症状缓解情况。

结果

研究对象包括17名女性(32%)和36名男性(68%),平均年龄67.8岁,均患有影响生活方式的间歇性跛行。仅选择短至中等长度的狭窄或闭塞病变(30.6%),平均长度为59.6毫米,使用紫杉醇涂层球囊进行经皮血管成形术。技术成功率为100%。在16个月时,初始通畅率达到92.0%(3例早期闭塞,2例再狭窄)。在6个月和9个月时分别有2例再次干预,导致临床驱动的靶病变血管重建率为3.2%。在16个月的随访结束时,除2例患者外,所有患者(96.2%)均无症状。2例患者在随访期间死亡(无手术相关死亡)。

结论

在常规临床实践中,使用紫杉醇涂层球囊对SFA进行血管成形术可获得优异的中期结果,1年再狭窄率为6.5%。该手术是作者首选的用于纠正SFA短至中等长度有症状狭窄的技术。

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