Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
J Endovasc Ther. 2019 Dec;26(6):810-815. doi: 10.1177/1526602819874474. Epub 2019 Sep 9.
To evaluate the safety and efficacy of endovascular treatment for iliac artery stenosis caused by Takayasu arteritis (TA). Twenty-three consecutive TA patients (mean age 28.6±9.5 years; 17 women) with 30 iliac artery stenoses underwent percutaneous transluminal angioplasty (PTA) and selective stent implantation between January 2007 and December 2016. All had claudication (Rutherford category 2 or 3). The changes in the Rutherford category, ankle-brachial index (ABI), 6-minute walking capacity, and adverse events were assessed. The success rate of endovascular therapy for iliac artery lesions was 93.3% (28/30). Guidewires could not cross either lesion in a patient with bilateral stenoses. Twenty-four lesions were treated by PTA alone and the other 4 lesions with provisional stents. One patient had a puncture site hematoma. Over an average of 4.8±3.3 years, 18 patients remained asymptomatic or had mild intermittent claudication. The other 4 patients developed moderate to severe intermittent claudication due to progression of a previously existing iliac lesion (n=1) or restenosis (n=3); all 4 underwent PTA. At the last follow-up, improvements were seen in the ABI (0.95±0.12 vs 0.51±0.22, p<0.001), 6-minute walking capacity (409.5±46.1 vs 272.6±32.3 m, p<0.001), and the Rutherford category of 22 patients. One patient died of a hemorrhagic stroke at 27 months due to uncontrolled hypertension. Endovascular therapy was safe and effective in treating TA patients with iliac artery stenosis, with good clinical outcomes in the long term.
评估血管内治疗多发性大动脉炎（TA）所致髂动脉狭窄的安全性和疗效。2007 年 1 月至 2016 年 12 月，连续 23 例 TA 患者（平均年龄 28.6±9.5 岁；17 例女性）共 30 处髂动脉狭窄行经皮腔内血管成形术（PTA）和选择性支架植入术。所有患者均有跛行（Rutherford 分类 2 或 3 级）。评估了 Rutherford 分类、踝肱指数（ABI）、6 分钟步行能力和不良事件的变化。髂动脉病变血管内治疗成功率为 93.3%（28/30）。一名双侧狭窄患者的导丝无法穿过任何一处病变。24 处病变单独行 PTA 治疗，4 处病变行临时支架治疗。1 例患者出现穿刺部位血肿。平均随访 4.8±3.3 年后，18 例患者无症状或间歇性跛行轻微。另 4 例患者因先前存在的髂动脉病变（1 例）或再狭窄（3 例）进展出现中度至重度间歇性跛行；所有 4 例患者均行 PTA 治疗。末次随访时，ABI（0.95±0.12 比 0.51±0.22，p<0.001）、6 分钟步行能力（409.5±46.1 比 272.6±32.3 m，p<0.001）和 22 例患者的 Rutherford 分类均得到改善。1 例患者因未控制的高血压在 27 个月时死于出血性中风。血管内治疗对 TA 合并髂动脉狭窄患者安全有效，长期临床效果良好。
