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序贯血管成形术治疗多节段病变患者的复杂外周动脉疾病

Complex Peripheral Arterial Disease in a Case of Multilevel Lesions Treated With Sequential Angioplasty.

作者信息

Patil Ishiqua V, Sharma Prerit, Pisulkar Gajanan, Salwan Ankur, Patel Maharshi

机构信息

Hospital Administration, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Interventional Radiology, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 May 24;16(5):e60982. doi: 10.7759/cureus.60982. eCollection 2024 May.

Abstract

Peripheral artery disease (PAD) is the buildup of calcium and fatty deposits in the arterial walls (atherosclerosis). This is an important clinical issue, specifically in cases with multilevel lesions. A patient underwent sequential angioplasty treatment for major PAD, which was characterized by multilevel lesions affecting both the infrapopliteal arteries. The proximal vessels and infrapopliteal vessels are mostly observed to be affected by PAD, thus the patient likely has PAD localized to the lower leg. In the femoropopliteal segment, lower extremity artery or aortic atherosclerotic occlusive disease can lead to significant outcomes. Severe claudication and pain during rest in both legs were observed in a patient with a history of hypertension and diabetes mellitus. With an angiography, the superficial femoral, popliteal, and tibial arteries have been shown to have major stenoses and occlusions. A progressive treatment was used because of the complexity of the lesions initiating with endovascular revascularization of the superficial femoral artery. The popliteal and tibial arteries were then repaired with angioplasty and stent placement. After the treatment, the patient's symptoms significantly improved, including elimination of their rest discomfort and claudication. Measurements of the ankle-brachial index (ABI) indicated that the affected limbs' perfusion was refined. Six months later, a follow-up angiography revealed intact vessels with no restenosis. This case report shows the successful outcome of recurrent angioplasty in curing complicated multilevel PAD, giving symptomatic relief and maintaining limb perfusion. This research is required to assess the long-term outcomes and longevity of this kind of treatment in patient populations that are comparable to others.

摘要

外周动脉疾病(PAD)是指动脉壁内钙和脂肪沉积物的堆积(动脉粥样硬化)。这是一个重要的临床问题,特别是在存在多级病变的情况下。一名患者因严重的PAD接受了序贯血管成形术治疗,其特征是多级病变累及双侧腘下动脉。近端血管和腘下血管大多被观察到受到PAD影响,因此该患者可能患有局限于小腿的PAD。在股腘段,下肢动脉或主动脉粥样硬化闭塞性疾病可导致严重后果。一名有高血压和糖尿病病史的患者出现了双腿严重间歇性跛行和静息痛。血管造影显示,股浅动脉、腘动脉和胫动脉存在严重狭窄和闭塞。由于病变的复杂性,采用了渐进性治疗,首先对股浅动脉进行血管内血运重建。然后通过血管成形术和支架置入修复腘动脉和胫动脉。治疗后,患者的症状明显改善,包括静息不适和间歇性跛行消失。踝肱指数(ABI)测量表明,患肢的灌注得到改善。六个月后,随访血管造影显示血管完好,无再狭窄。本病例报告显示了反复血管成形术在治疗复杂多级PAD方面的成功结果,缓解了症状并维持了肢体灌注。需要开展这项研究以评估这种治疗方法在与其他患者群体相似的人群中的长期疗效和寿命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d32d/11194135/8ff6af43343f/cureus-0016-00000060982-i01.jpg

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