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血管腔内治疗时代的血栓闭塞性脉管炎管理

Management of Buerger's Disease in Endovascular Era.

作者信息

Ghoneim Baker M, Karmota Ahmed G, Abuhadema Ahmed M, Shaker Ahmed A, Abdelmawla Hany M, Nasser Mahmoud M, Elmahdy Hossam Y, Mostafa Hesham A, Khairy Hussein M

机构信息

Vascular Surgery Department, Faculty of Medicine, Cairo University, Egypt.

出版信息

Int J Angiol. 2019 Sep;28(3):173-181. doi: 10.1055/s-0039-1685200. Epub 2019 Apr 19.

Abstract

This study was aimed to report data on the feasibility, safety, and effectiveness of endovascular procedures in a thromboangiitis obliterans diagnosed patients presenting with critical limb ischemia (CLI). Prospective study conducted on patients affected by Buerger's disease who presented to our center along 2 years. Clinical, radiological, and patient-based outcomes were recorded at 3, 6, and 12 months after the intervention. Total 39 patients were included in the study. Fifteen (38.5%) patients underwent percutaneous transluminal angioplasty, another 15 patients (38.5%) underwent follow-up on medical treatment, there are four other patients (10.3%) underwent surgical bypass, and five (12.8%) patients underwent lumbar sympathectomy. The 12 months' outcome showed 66.7% technical success in endovascular group with 46.7% patency rate ( -value = 0.06), 86.7% limb salvage rate (LSR; -value < 0.04), and 66.7% clinical improvement ( -value = 0.005). The endovascular management of Buerger's disease is feasible, save, and effective with high rate of LSR and clinical improvement.

摘要

本研究旨在报告血管内介入治疗在诊断为血栓闭塞性脉管炎且伴有严重肢体缺血(CLI)患者中的可行性、安全性及有效性。对两年来就诊于本中心的血栓闭塞性脉管炎患者进行前瞻性研究。在干预后3个月、6个月和12个月记录临床、影像学及基于患者的结局。本研究共纳入39例患者。15例(38.5%)患者接受了经皮腔内血管成形术,另外15例(38.5%)患者接受药物治疗随访,另有4例(10.3%)患者接受了外科旁路手术,5例(12.8%)患者接受了腰交感神经切除术。12个月的结局显示血管内治疗组技术成功率为66.7%,通畅率为46.7%(P值=0.06),肢体挽救率(LSR)为86.7%(P值<0.04),临床改善率为66.7%(P值=0.005)。血栓闭塞性脉管炎的血管内治疗可行、安全且有效,具有较高的肢体挽救率和临床改善率。

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