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股浅动脉闭塞的血管内介入治疗:不同方法、技术及随访

Endovascular Interventions to Superficial Femoral Artery Occlusion: Different Approaches, Technique, and Follow-up.

作者信息

Krishnappa Santhosh, Rachaiah Jayasheelan Mambally, Mariappa Harsha Mullusoge, Doddamadaiah Chaitra, Nanjappa Manjunath Cholenahally

机构信息

Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India.

出版信息

Heart Views. 2020 Apr-Jun;21(2):65-74. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_34_19. Epub 2020 Jun 29.

Abstract

BACKGROUND

Superficial femoral artery lesion is one of the main causes for intermittent claudication or critical limb ischemia. Percutaneous transluminal angioplasty is one of the approved therapies for this medical entity. Anatomical factors should be considered in choosing the right approach and puncture.The purpose of this study is to discuss the anatomical, radiological, and technical factors which determine the preference of various approaches and to determine its safety, efficacy, and mid-term clinical and radiological outcome.

METHODS

Retrospectively, data were collected from patients who underwent angioplasty to superficial femoral arteries for total occlusion from January 2015 and June 2018 in our center, we performed angioplasty to 59 occluded superficial femoral artery patients at our center. The ipsilateral femoral artery, ipsilateral popliteal artery, contralateral femoral artery, or upper limb approaches were used depending on the various anatomical factors determined by radiological imaging before the procedure.

RESULTS

Acute success rate was 91.52%. There were no significant periprocedural complications. At the latest clinical follow-up of mean 25.8 months (10-51), a restenosis rate of 16.67% in infrainguinal arteries and 5.88% in suprainguinal arteries were noted.

CONCLUSIONS

Percutaneous transluminal angioplasty of superficial femoral artery is a proven, viable, safer, and effective option, with good mid-term clinical results and patency rates. Different approaches to be chosen depends on the anatomical and technical factors to get the best possible outcome.

摘要

背景

股浅动脉病变是间歇性跛行或严重肢体缺血的主要原因之一。经皮腔内血管成形术是针对这一病症的一种已获批准的治疗方法。在选择正确的入路和穿刺点时应考虑解剖因素。本研究的目的是探讨决定各种入路选择倾向的解剖学、放射学和技术因素,并确定其安全性、有效性以及中期临床和放射学结果。

方法

回顾性收集2015年1月至2018年6月在本中心接受股浅动脉闭塞血管成形术患者的数据,本中心对59例股浅动脉闭塞患者进行了血管成形术。根据术前放射学成像确定的各种解剖因素,采用同侧股动脉、同侧腘动脉、对侧股动脉或上肢入路。

结果

急性成功率为91.52%。围手术期无明显并发症。在平均25.8个月(10 - 51个月)的最新临床随访中,发现股下动脉再狭窄率为16.67%,股上动脉再狭窄率为5.88%。

结论

股浅动脉经皮腔内血管成形术是一种已被证实的、可行的、更安全有效的选择,具有良好的中期临床效果和通畅率。应根据解剖和技术因素选择不同的入路以获得最佳结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/175e/7507906/25a7761326eb/HV-21-65-g001.jpg

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