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[下肢动脉疾病中髂动脉和股腘动脉经皮腔内血管成形术的比较研究]

[A comparative study of percutaneous transluminal angioplasty of the iliac and femoropopliteal arteries in arterial disease of the lower extremities].

作者信息

Glock Y, Joffre F, Boccalon H, Chaffai M, Puel P

出版信息

Can J Surg. 1984 Jul;27(4):361-4.

PMID:6234980
Abstract

The authors compared the anatomo-radiologic data from a series of 100 consecutive percutaneous transluminal angioplasties (PTA), as well as the immediate and long-term results as a function of the level of the lesion--iliac or femoropopliteal. Proximal to the thigh, there were 57 PTAs, 36 of the common iliac and 21 of the external iliac. In the lower thigh, there were 43 PTAs, 9 of the upper part of the popliteal artery and 34 of the external femoral artery. Percutaneous transluminal angioplasty of the common iliac lesion was dominant in patients under 60 years of age (p less than 0.05). At the iliac level, 89% of the patients had severe claudication; at the femoropopliteal level, 39% had trophic problems. The "dominant" or "accessory" character of the lesion did not modify the indication for the procedure, regardless of the level. Segmental thrombosis accounted for 44.2% of the femoropopliteal PTA indications, compared with 7% at the iliac level (p less than 0.04). The failure rate was less at the iliac than at the femoropopliteal level. Follow-up was available for 86.6% of the patients for an average of 22 months. The systolic indices at the thigh after iliac PTA and at the ankle after femoropopliteal PTA were significantly increased (p less than 0.01). At the femoropopliteal level, 74% of the patients were totally asymptomatic. There was one failure (3.8%); amputation at thigh level was carried out 12 months after the PTA. At the iliac level, improvement was observed in 91% of the patients and 70% became asymptomatic. The overall success rate (clinical patency and improvement) was 92% +/- 0.09%, based on the life-table method.

摘要

作者比较了100例连续经皮腔内血管成形术(PTA)的解剖放射学数据,以及根据病变部位(髂动脉或股腘动脉)得出的近期和远期结果。在大腿近端,有57例PTA,其中36例为髂总动脉病变,21例为髂外动脉病变。在大腿下部,有43例PTA,其中9例为腘动脉上段病变,34例为股外动脉病变。60岁以下患者中,髂总动脉病变的经皮腔内血管成形术占主导地位(p<0.05)。在髂动脉水平,89%的患者有严重跛行;在股腘动脉水平,39%的患者有营养障碍问题。病变的“优势”或“次要”特征并不改变手术指征,无论病变部位如何。节段性血栓形成占股腘动脉PTA指征的44.2%,而在髂动脉水平为7%(p<0.04)。髂动脉水平的失败率低于股腘动脉水平。86.6%的患者获得随访,平均随访时间为22个月。髂动脉PTA后大腿的收缩指数和股腘动脉PTA后踝部的收缩指数显著升高(p<0.01)。在股腘动脉水平,74%的患者完全无症状。有1例失败(3.8%);PTA术后12个月在大腿水平进行了截肢。在髂动脉水平,91%的患者病情有改善,70%的患者无症状。根据寿命表法,总体成功率(临床通畅和改善)为92%±0.09%。

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