1 Cardiovascular Center Tokeidai Memorial Hospital, Sapporo, Hokkaido, Japan.
J Endovasc Ther. 2018 Apr;25(2):192-200. doi: 10.1177/1526602818756610. Epub 2018 Feb 11.
To describe the feasibility of balloon angioplasty using a long balloon for chronic femoropopliteal occlusions by evaluating angiographic dissection patterns for optimization of outcomes in balloon angioplasty.
A retrospective, single-center analysis examined 101 symptomatic patients (mean age 75.6±9.9 years; 65 men) with single de novo femoropopliteal occlusive lesions treated with balloon angioplasty between August 2012 and October 2016. The patients were classified into 2 groups for comparison of angiographic dissection patterns: 51 patients were treated with balloon angioplasty using long balloons (L-BA; defined as ≥220 mm in length) and 50 patients were treated with short balloon angioplasty (S-BA; defined as <150-mm-long balloons).
Severe vessel dissection patterns, defined as type C or higher, were fewer in the L-BA group (47.1% vs 70.0% in the S-BA group, p=0.019) and the total dissection length was shorter (92.7±72.6 vs 160.4±84.6 mm in the S-BA group, p<0.001). Although the results showed no significant differences between the two groups regarding the length of chronic total occlusions (L-BA: 228.6±73.2 vs S-BA: 226.0±53.8 mm, p=0.83), inflation pressure (L-BA; 8.2±2.6 vs S-BA: 8.1±2.9 atm, p=0.86), and the other lesion characteristics, inflation time was significantly longer in the L-BA group (161.2±68.7 seconds vs 51.1±54.0 seconds in the S-BA group, p<0.001). Multivariate analysis identified a balloon length ≥220 mm as an independent negative predictor of severe vessel dissection (odds ratio 0.29, 95% confidence interval 0.11 to 0.83, p=0.02).
Using long balloons for balloon angioplasty may help prevent severe vessel dissection in chronic femoropopliteal occlusions.
通过评估血管成形术中的血管夹层模式，以优化球囊扩张术的结果，来描述使用长球囊治疗慢性股腘动脉闭塞的可行性。
回顾性单中心分析了 2012 年 8 月至 2016 年 10 月期间采用球囊扩张治疗的 101 例有症状的初次股腘动脉闭塞患者（平均年龄 75.6±9.9 岁；65 例男性）。将患者分为两组进行比较，以比较血管造影的夹层模式：51 例患者接受长球囊（L-BA；定义为长度≥220mm）治疗，50 例患者接受短球囊（S-BA；定义为<150mm 长球囊）治疗。
L-BA 组严重血管夹层模式（定义为 C 型或更高）较少（47.1%比 S-BA 组的 70.0%，p=0.019），总夹层长度较短（92.7±72.6mm 比 S-BA 组的 160.4±84.6mm，p<0.001）。尽管两组在慢性完全闭塞的长度方面无显著差异（L-BA：228.6±73.2mm 比 S-BA：226.0±53.8mm，p=0.83）、充气压力（L-BA；8.2±2.6atm 比 S-BA：8.1±2.9atm，p=0.86）和其他病变特征，但 L-BA 组的充气时间明显较长（161.2±68.7s 比 S-BA 组的 51.1±54.0s，p<0.001）。多变量分析显示，球囊长度≥220mm 是严重血管夹层的独立负预测因子（比值比 0.29，95%置信区间 0.11 至 0.83，p=0.02）。
在慢性股腘动脉闭塞中使用长球囊进行球囊扩张可能有助于预防严重的血管夹层。
