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[下肢周围动脉闭塞性疾病的经皮腔内血管成形术(PTA)]

[Percutaneous transluminal angioplasty (PTA) in peripheral arterial occlusive disease of the lower extremities].

作者信息

Minar E, Ahmadi R A, Ehringer H, Marosi L, Czembirek H, Konecny U

出版信息

Wien Klin Wochenschr. 1986 Jan 24;98(2):33-40.

PMID:2938339
Abstract

The results of 185 percutaneous transluminal angioplasties (PTA) of the iliac (n = 62) and femoropopliteal segment (n = 123) with a double-lumen balloon catheter (Olbert) are presented. The mean age of the 150 patients was 64 years (range 39 to 91). While there were 87% stenoses and only 13% occlusions of the iliac segment, in the femoropopliteal segment the respective ratios were 46% and 54%. 71% of the patients suffered from intermittent claudication and 29% were severely ischaemic cases (Fontaine stages III and IV). Platelet inhibition was induced by means of acetylsalicylic acid 1 g/day prior to and during the procedure, and afterwards heparin was also administered for 4 days. The primary success rate in the iliac segment of 88.7% (of which 12.9% were classified as a partial success) was identical with that in the femoropopliteal region. Stenoses were successfully treated in 94.6% cases (9.9% being partial successes), occlusions in 79.7% (partial success in 16.2% of these cases). Complications occurred in 8.6% of cases, whereby surgical correction was required in half of these. When the procedure was complicated by major embolization into the distal popliteal artery, this was handled successfully by means of local thrombolytic therapy. Over the follow-up period of up to 21 months reocclusion--or high-grade restenosis--occurred in 26 patients. The cumulative patency rate 1 year after PTA was 92% for the iliac and 70% for the femoropopliteal segment.

摘要

本文呈现了使用双腔球囊导管(奥尔伯特)对185例髂动脉(n = 62)和股腘动脉段(n = 123)进行经皮腔内血管成形术(PTA)的结果。150例患者的平均年龄为64岁(范围39至91岁)。髂动脉段狭窄占87%,闭塞仅占13%,而在股腘动脉段,相应比例分别为46%和54%。71%的患者患有间歇性跛行,29%为严重缺血病例(Fontaine分期III和IV期)。在手术前及手术期间通过每天服用1克乙酰水杨酸诱导血小板抑制,术后还给予肝素4天。髂动脉段的初次成功率为88.7%(其中12.9%为部分成功),与股腘动脉区域相同。狭窄病例的成功治疗率为94.6%(9.9%为部分成功),闭塞病例为79.7%(其中16.2%为部分成功)。8.6%的病例出现并发症,其中一半需要手术矫正。当手术因主要栓塞至腘动脉远端而复杂化时,通过局部溶栓治疗成功处理。在长达21个月的随访期内,26例患者发生再闭塞或高度再狭窄。PTA术后1年,髂动脉段的累积通畅率为92%,股腘动脉段为70%。

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