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髂动脉支架置入术后的晚期再梗阻:经皮治疗

Late reobstruction in iliac arterial stents: percutaneous treatment.

作者信息

Vorwerk D, Guenther R W, Schürmann K, Wendt G

机构信息

Department of Diagnostic Radiology, Technical University of Aachen, Germany.

出版信息

Radiology. 1995 Nov;197(2):479-83. doi: 10.1148/radiology.197.2.7480697.

Abstract

PURPOSE

To retrospectively analyze in a nonrandomized fashion the efficacy of percutaneous reintervention in obstructed iliac stents.

MATERIALS AND METHODS

In 21 symptomatic patients with iliac lesions, 26 reinterventions (16 for stent occlusion and 10 for stent stenosis) were performed. Restenoses were treated with balloon dilation and either atherectomy or stent placement. Reocclusions were treated with atherectomy or aspiration thrombectomy and then recanalization with balloon dilation and selective stent placement.

RESULTS

Balloon angioplasty for stent stenosis was effective in all but one patient. Recanalization was successful in 14 of 16 patients with stent occlusion. The mean period of patency after reintervention was 18 months +/- 15. Cumulative stent stenosis patency after reintervention was 87% after 1 year. Stent occlusion patency was 57%. Recurrent stent obstruction occurred in eight of 24 (33%) patients with successful primary interventions.

CONCLUSION

Percutaneous reintervention for both stent stenosis and occlusion is feasible with a moderate complication rate and may be attempted before surgery.

摘要

目的

以非随机方式回顾性分析经皮再干预治疗髂动脉支架阻塞的疗效。

材料与方法

对21例有症状的髂动脉病变患者进行了26次再干预(16次针对支架闭塞,10次针对支架狭窄)。再狭窄采用球囊扩张及旋切术或支架置入治疗。再闭塞采用旋切术或血栓抽吸术治疗,然后通过球囊扩张和选择性支架置入进行再通。

结果

除1例患者外,球囊血管成形术治疗支架狭窄均有效。16例支架闭塞患者中有14例再通成功。再干预后的平均通畅期为18个月±15个月。再干预后1年,支架狭窄累积通畅率为87%。支架闭塞通畅率为57%。24例初次干预成功的患者中有8例(33%)发生支架再阻塞。

结论

经皮再干预治疗支架狭窄和闭塞均可行,并发症发生率中等,可在手术前尝试。

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