Gardiner G A, Meyerovitz M F, Stokes K R, Clouse M E, Harrington D P, Bettmann M A
Radiology. 1986 Apr;159(1):201-8. doi: 10.1148/radiology.159.1.2937082.
Four hundred fifty-three percutaneous transluminal angioplasties in 352 patients were reviewed to determine the frequency, distribution, and cause of complications. The primary success rate was 89% (81%-82% for renal and distal runoff vessels, 91%-95% for the iliofemoral arteries). Fifty-nine complications occurred in 53 patients, including 20 puncture site complications, the most frequent being hematoma. The most important angioplasty complication was acute occlusion of the arterial lumen attributed to acute thrombosis (2%). Subintimal passage of the guide wire/catheter (2%) may also cause luminal compromise. Arterial dissection following balloon dilatation (1%) and distal emboli (1.5%) were less important clinically, and vessel wall rupture was rare (0.4%). Complications were two to four times more frequent for renal and distal popliteal/tibial compared with iliofemoral angioplasties; the lower success and higher complication rates are attributed to greater technical difficulty and the increased importance of spasm. Operator experience and technical refinements play an important role in reducing occurrence of serious complications. The frequency and severity of angioplasty complications compare favorably with the alternative surgical procedure.
回顾了352例患者的453次经皮腔内血管成形术，以确定并发症的发生率、分布及原因。主要成功率为89%（肾动脉及远端流出血管为81%-82%，髂股动脉为91%-95%）。53例患者发生了59例并发症，包括20例穿刺部位并发症，最常见的是血肿。血管成形术最重要的并发症是急性血栓形成导致的动脉腔急性闭塞（2%）。导丝/导管进入内膜下（2%）也可能导致管腔狭窄。球囊扩张后动脉夹层（1%）和远端栓子（1.5%）在临床上不太重要，血管壁破裂罕见（0.4%）。与髂股血管成形术相比，肾动脉及腘动脉/胫动脉远端的并发症发生率高出两到四倍；成功率较低和并发症发生率较高归因于技术难度更大以及痉挛的重要性增加。术者经验和技术改进在减少严重并发症的发生方面起着重要作用。血管成形术并发症的发生率和严重程度与替代手术相比具有优势。
