Department of Vascular and Endovascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China.
Department of Vascular and Endovascular Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China.
Ann Vasc Surg. 2023 Jan;88:182-190. doi: 10.1016/j.avsg.2022.08.004. Epub 2022 Aug 22.
This study evaluated the midterm results of endovascular therapy (EVT) for Trans-Atlantic Inter-Society (TASC) II D femoropopliteal lesions in patients with critical limb ischemia (CLI).
Fifty seven limbs of 54 patients with CLI due to TASC II D femoropopliteal lesions who underwent EVT at the First Hospital of Hebei Medical University were retrospectively analysed in a single-centre, observational study. The patient characteristics, endovascular procedural details, freedom from target lesion revascularization (TLR), patency rates, ulcer healing rate, and limb salvage rate were accessed.
The patients' mean age was 68.2 ± 8.2 years. All patients were treated by EVT. The final technical success rate was 98.2% (56/57). There were 23 cases of pain at rest, 18 cases of ulcer, and 15 cases of gangrene. The median length of the treated segment was 286 ± 42 mm (56/56) and the mean number of stents placed per patient was 2.0 ± 0.8 (49/56). The postoperative ankle-brachial index was significantly higher than that of the preoperative ankle-brachial index (P < 0.05). The perioperative complication rate was 10.7% (6/56). The restenosis or occlusion rate was 44.6% (25/56). The estimated rates of freedom from TLR at 1 year, 2 years, and 3 years were 86.8%, 67.0%, and 62.5%, respectively. A univariate analysis showed that predictors of freedom from TLR were the number of runoff vessels, length of the lesion, and complexity of the lesion, while predictors for restenosis or occlusion were the length and the complexity of the lesion. The ulcer healing rate was 93.8%. The limb salvage rates were 76.4%, 74.4%, and 70.9% at 1, 2, and 3 years after treatment, respectively.
The midterm outcomes of EVT for TASC II D femoropopliteal lesions in patients with CLI indicated that this treatment approach is safe and effective and is clinically applicable.
本研究评估了腔内治疗（EVT）治疗伴有严重肢体缺血（CLI）的跨大西洋腔内治疗协会（TASC）II D 型股腘病变患者的中期结果。
回顾性分析河北医科大学第一医院 54 例 TASC II D 型股腘病变伴有 CLI 的 57 条肢体接受 EVT 治疗的单中心观察性研究患者。评估患者特征、腔内治疗程序细节、无靶病变血运重建（TLR）、通畅率、溃疡愈合率和肢体存活率。
患者平均年龄为 68.2±8.2 岁。所有患者均接受 EVT 治疗。最终技术成功率为 98.2%（56/57）。有 23 例患者有静息痛，18 例有溃疡，15 例有坏疽。治疗节段的中位长度为 286±42mm（56/56），每位患者平均放置支架 2.0±0.8 个（49/56）。术后踝肱指数明显高于术前踝肱指数（P<0.05）。围手术期并发症发生率为 10.7%（6/56）。再狭窄或闭塞率为 44.6%（25/56）。1 年、2 年和 3 年 TLR 无复发率分别为 86.8%、67.0%和 62.5%。单因素分析显示，TLR 无复发的预测因素是流出血管的数量、病变的长度和病变的复杂性，而再狭窄或闭塞的预测因素是病变的长度和复杂性。溃疡愈合率为 93.8%。治疗后 1、2、3 年的肢体存活率分别为 76.4%、74.4%和 70.9%。
EVT 治疗伴有 CLI 的 TASC II D 型股腘病变的中期结果表明，该治疗方法安全有效，具有临床应用价值。
