经皮腔内血管成形术治疗锁骨下动脉严重狭窄或闭塞的效果。
Effects of percutaneous endovascular angioplasty for severe stenosis or occlusion of subclavian artery.
机构信息
Stroke Center, Cerebrovascular Disease Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.
出版信息
Sci Rep. 2024 Jun 21;14(1):14290. doi: 10.1038/s41598-024-65302-y.
To investigate the effect and safety of percutaneous endovascular angioplasty (PEA) with optional stenting for the treatment of severe stenosis or occlusion of subclavian artery, patients with severe stenosis ≥ 70% or occlusion of subclavian artery treated with PEA were retrospectively enrolled. The clinical data were analyzed. A total of 222 patients were retrospectively enrolled, including 151 males (68.0%) and 71 females (32.0%) aged 48-86 (mean 63.9 ± 9.0) years. Forty-seven (21.2%) patients had comorbidities. Subclavian artery stenosis ≥ 70% was present in 201 (90.5%) patients and complete subclavian occlusion in 21 (9.5%) cases. Angioplasty was successfully performed in all (100%) patients. Balloon-expandable stents were used in 190 (85.6%) cases, and self-expandable stents in 20 (9.0%) cases. Only 12 (5.4%) cases were treated with balloon dilation only. Among 210 patients treated with stent angioplasty, 71 (33.8% or 71/210) cases underwent balloon pre-dilation, 139 (66.2% or 139/210) had direct deployment of balloon-expandable stents, and 2 (1.0% or 2/210) experienced balloon post-dilation. Distal embolization protection devices were used in 5 (2.3% or 5/222) cases. Periprocedural complications occurred in 3 (1.4%) patients, including aortic dissection in 2 (0.9%) cases and right middle cerebral artery embolism in 1 (0.5%). No hemorrhage occurred. Among 182 (82.0%) patients with 6-month follow-up, restenosis > 70% occurred in 1 (0.5%) patient, and among 68 (30.6%) patients with 12-month follow-up, restenosis > 70% took place in 11 (16.2%) patients. Percutaneous endovascular angioplasty can be safely and efficiently performed for the treatment of severe stenosis ≥ 70% or occlusion of subclavian artery.
为了研究经皮腔内血管成形术（PEA）联合可选支架置入治疗锁骨下动脉重度狭窄或闭塞的效果和安全性，回顾性纳入了接受 PEA 治疗的锁骨下动脉重度狭窄≥70%或闭塞的患者。分析了临床资料。共回顾性纳入 222 例患者，男 151 例（68.0%），女 71 例（32.0%），年龄 48-86 岁，平均 63.9±9.0 岁。47 例（21.2%）合并其他疾病。201 例（90.5%）患者锁骨下动脉狭窄≥70%，21 例（9.5%）患者锁骨下动脉完全闭塞。所有患者均成功实施了血管成形术。190 例（85.6%）患者使用球囊扩张支架，20 例（9.0%）患者使用自膨式支架，12 例（5.4%）患者仅行单纯球囊扩张。210 例支架血管成形术患者中，71 例（33.8%或 71/210）行球囊预扩张，139 例（66.2%或 139/210）行球囊扩张支架直接置入，2 例（1.0%或 2/210）行球囊后扩张。5 例（2.3%或 5/222）患者使用远端栓塞保护装置。3 例（1.4%）患者发生围手术期并发症，包括 2 例（0.9%）主动脉夹层和 1 例（0.5%）右侧大脑中动脉栓塞。无出血事件发生。182 例（82.0%）患者获得 6 个月随访，1 例（0.5%）患者再狭窄率＞70%；68 例（30.6%）患者获得 12 个月随访，11 例（16.2%）患者再狭窄率＞70%。经皮腔内血管成形术联合支架置入治疗锁骨下动脉重度狭窄≥70%或闭塞安全有效。
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