Chi Guoqing, Ding Mingchao
Department of Interventional Vascular Surgery, Aerospace Center Hospital, Beijing, China.
Front Surg. 2021 Dec 23;8:646978. doi: 10.3389/fsurg.2021.646978. eCollection 2021.
Lower extremity artery disease (LEAD) increases sharply with age and results in severe burden in individuals and in society. This study aimed to compare the efficiency of simple superficial femoral artery stenting (SFAS) and the hybrid operation, such as combined SFAS and deep femoral artery profundoplasty (DFAP), in the treatment of Chinese patients with LEAD, classified as Rutherford grades 3-5. There were 200 patients with LEAD classified as Rutherford grades 3-5 included in the simple SFAS group ( = 100) and the combined SFAS and DFAP group ( = 100). All the patients had median age of 71 years, and there were 143 males (71.5%). Not only the increase rate of ankle brachial index (ABI), but also reduction rate of Rutherford grade, were significantly higher after surgery in the combined SFAS and DFAP group than in the simple SFAS group ( < 0.05 for all). The patency rate of patients in the combined SFAS and DFAP group was significantly higher than that of patients in the simple SFAS group during the follow-up ( < 0.05). Proportion of amputation and claudication distance <200 m had no significant difference between the two groups during the 2-year follow-up ( > 0.05 for all). This study demonstrated that, compared with SFAS, combined SFAS and DFAP improved not only the ABI and the Rutherford grade after surgery but also the patency rate during the follow-up in Chinese patients with LEAD. Hybrid operation has significant value in alleviating clinical symptoms after surgery, and, thereby, improving vascular prognosis in Chinese patients.
下肢动脉疾病(LEAD)随年龄急剧增加,给个人和社会带来沉重负担。本研究旨在比较单纯股浅动脉支架置入术(SFAS)与杂交手术(如联合SFAS和股深动脉成形术(DFAP))治疗中国Rutherford分级为3 - 5级的LEAD患者的疗效。单纯SFAS组(n = 100)和联合SFAS与DFAP组(n = 100)纳入了200例Rutherford分级为3 - 5级的LEAD患者。所有患者的中位年龄为71岁,男性有143例(71.5%)。联合SFAS与DFAP组术后踝肱指数(ABI)的增加率以及Rutherford分级的降低率均显著高于单纯SFAS组(均P < 0.05)。联合SFAS与DFAP组患者在随访期间的通畅率显著高于单纯SFAS组(P < 0.05)。在2年随访期间,两组间截肢比例和跛行距离<200 m无显著差异(均P > 0.05)。本研究表明,与SFAS相比,联合SFAS与DFAP不仅能改善中国LEAD患者术后的ABI和Rutherford分级,还能提高随访期间的通畅率。杂交手术在缓解术后临床症状、从而改善中国患者血管预后方面具有重要价值。