Ata Emin Can, Şenel Muharrem
Department of Cardiovascular Surgery, Private Eskişehir Anadolu Hospital, Eskişehir, Turkey.
Department of Cardiovascular Surgery, Private Su Hospital, İzmir, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Jul 3;26(3):414-421. doi: 10.5606/tgkdc.dergisi.2018.15503. eCollection 2018 Jul.
In this study, we present our center's experience on percutaneous transluminal angioplasty/stenting.
Between January 2015 and March 2017, a total of 40 patients (34 males, 6 females; mean age 64.5±8.7 years; range, 49 to 85 years) who were treated in our clinic due to totally occluded iliofemoral artery disease were included. There were 45 legs and 51 targeted vessels. Hybrid procedure was performed to those patients with iliofemoral or femoropopliteal bypass grafts.
A total of 48 target vessels (94.1%) were implanted using 55 stents at the initial attempt. Failed three target vessels (5.9%) were treated by surgical revascularization. There was no procedure-related mortality. Below-knee amputation was performed in one patient after 70 days. Two patients underwent single-finger amputation. Contrast nephropathy occurred in one patient and this patient was treated medically. The mean follow-up was 16.7±5 (range, 8 to 29) months. After follow-up, 41 stents were found to be patent without any intervention, and the primary patency rate was 74.5%. Five stent thrombosis patients (12.5%) were treated at different times.
Our study results suggest that percutaneous transluminal angioplasty/stent treatment may be advisable in patients with significant comorbidities. The lower rates of complication in the stent series strongly suggest that, in experienced hands, percutaneous transluminal angioplasty/stent can offer lower procedural risks than surgical revascularization. Hybrid procedure is likely to be a reasonable choice for previously intervened comorbid patients for limb salvage.
在本研究中，我们介绍了我们中心经皮腔内血管成形术/支架置入术的经验。
纳入2015年1月至2017年3月期间因髂股动脉完全闭塞性疾病在我们诊所接受治疗的40例患者（34例男性，6例女性；平均年龄64.5±8.7岁；范围49至85岁）。共有45条腿和51条目标血管。对那些患有髂股或股腘旁路移植术的患者进行了杂交手术。
首次尝试时，共使用55枚支架植入了48条目标血管（94.1%）。3条目标血管（5.9%）植入失败，通过外科血管重建术进行了治疗。无手术相关死亡。1例患者在70天后进行了膝下截肢。2例患者进行了单指截肢。1例患者发生造影剂肾病，该患者接受了药物治疗。平均随访时间为16.7±5（范围8至29）个月。随访后，发现41枚支架通畅，无需任何干预，主要通畅率为74.5%。5例支架血栓形成患者（12.5%）在不同时间接受了治疗。
我们的研究结果表明，对于有严重合并症的患者，经皮腔内血管成形术/支架治疗可能是可取的。支架系列中较低的并发症发生率强烈表明，在经验丰富的医生手中，经皮腔内血管成形术/支架可以提供比外科血管重建术更低的手术风险。杂交手术可能是先前接受过干预的合并症患者挽救肢体的合理选择。
