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经皮腔内血管成形术的并发症

[Complications of percutaneous transluminal angioplasty].

作者信息

Murakami R, Korogi Y, Hirai T, Sakamoto Y, Hamatake S, Ikushima I, Takahashi M

机构信息

Department of Radiology, Kumamoto University, School of Medicine.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1995 Jun;55(7):470-6.

PMID:7644337
Abstract

Four hundred twenty-three percutaneous transluminal angioplasties with 383 percutaneous arterial punctures in 346 patients were reviewed to determine the frequency, distribution and causes of complications. Complications were seen at the angioplasty site and puncture site along with miscellaneous complications, the incidence rates being 9.5% (40 of 423 PTAs), 11.7% (45 of 383 punctures), and 2.0% (7 of 346 patients), respectively. Major complications occurred in 20 cases, and surgical procedures were required in six cases. Mortality as a complication of PTA was not seen. Angioplasty site complications included 13 spasms, eight dissections, five thromboses, 13 distal embolizations and one perforation. Most puncture site complications were benign hematomas, but there were other types such as a pseudoaneurysm requiring bypass grafting, a thrombosis requiring thrombolysis and a large quantity of bleeding requiring transfusion. The incidence of angioplasty site complications was significantly higher (p < 0.01) in the procedure for complete occlusion than that for stenosis. The puncture site and miscellaneous complications were also more frequent in complete occlusions. The incidence of complications increased with age, although this tendency did not reach statistical significance.

摘要

回顾了346例患者进行的423例经皮腔内血管成形术(PTA)及383次经皮动脉穿刺,以确定并发症的发生率、分布及原因。血管成形术部位、穿刺部位以及其他各类并发症均有发生,发生率分别为9.5%(423例PTA中有40例)、11.7%(383次穿刺中有45例)和2.0%(346例患者中有7例)。发生严重并发症20例,其中6例需要进行外科手术。未出现作为PTA并发症的死亡病例。血管成形术部位并发症包括13例痉挛、8例夹层、5例血栓形成、13例远端栓塞和1例穿孔。大多数穿刺部位并发症为良性血肿,但也有其他类型,如需要进行旁路移植术的假性动脉瘤、需要溶栓的血栓形成以及需要输血的大量出血。完全闭塞手术中血管成形术部位并发症的发生率显著高于狭窄手术(p < 0.01)。完全闭塞时穿刺部位及其他各类并发症也更为常见。并发症的发生率随年龄增加而升高,尽管这一趋势未达到统计学意义。

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