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[术中腔内血管成形术3年经验——一项回顾性研究]

[3 years' experience with intraoperative transluminal angioplasty--a retrospective study].

作者信息

Rendl K H, Prenner K

出版信息

Langenbecks Arch Chir. 1983;360(4):295-301. doi: 10.1007/BF01257433.

Abstract

From 1980-1982 45 transluminal angioplasties were carried out intraoperatively (ITA) in 42 patients with a mean age of 59 years for the improvement of the inflow or outflow in connection with conventional reconstructive techniques (n = 26), as angioplasty alone with surgical exposure of the arteries for introduction of the catheter material (n = 10) and after thrombectomy for elimination of the cause of occlusion (n = 9). The pelvic vascular bed was dilated eight times, the femoropopliteal vessels 30 times and a stenosed hemodialysis shunt was dilated five times. Intraoperatively, perforation occurred once in the pelvic region. Four occlusions (1 X pelvis, 3 X femoropopliteal) could not be passed with instruments. In 8.8% immediate occlusions always occurred femoropopliteally. The causes were vessel wall dissection and calcification. One patient died for cardic reasons 14 days postoperatively. We saw one recurrent occlusion in the postoperative observation period of 9.7 months (0.5-28 months), also in this case in the femoral region. Since all recurrent occlusions occurred femoropopliteally in this region the indication for ITA must be made strictly. The dilatation of the pelvic arteries displays good long term results with a slight risk and should even be used intraoperatively as the treatment of first choice in the presence of appropriate morphology.

摘要

1980年至1982年期间,对42例平均年龄59岁的患者进行了45次术中腔内血管成形术(ITA),以改善与传统重建技术相关的流入或流出情况(n = 26),如单独进行血管成形术并通过手术暴露动脉以引入导管材料(n = 10),以及在血栓切除术后消除阻塞原因(n = 9)。盆腔血管床扩张了8次,股腘血管扩张了30次,狭窄的血液透析分流管扩张了5次。术中,盆腔区域发生1次穿孔。4处阻塞(1处盆腔、3处股腘)无法用器械通过。在8.8%的病例中,股腘部位总是立即发生阻塞。原因是血管壁夹层和钙化。1例患者术后14天因心脏原因死亡。在9.7个月(0.5 - 28个月)的术后观察期内,我们发现1例复发性阻塞,同样发生在股部区域。由于所有复发性阻塞均发生在该区域的股腘部位,因此必须严格掌握ITA的适应证。盆腔动脉扩张显示出良好的长期效果,风险较小,在存在合适形态时甚至应在术中作为首选治疗方法使用。

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