Murphy K D, Encarnacion C E, Le V A, Palmaz J C
Department of Radiology, University of Texas Health Science Center, San Antonio 78284-7800 USA.
J Vasc Interv Radiol. 1995 May-Jun;6(3):321-9. doi: 10.1016/s1051-0443(95)72815-9.
The long-term efficacy of iliac artery stent placement with the Palmaz stent was evaluated for treatment of limb ischemia.
Iliac stent implantation for limb ischemia was performed on 108 limbs in 83 patients. Eighty patients (96.4%) were followed up clinically from 1 to 70 months (mean, 25.8 months), and 30 patients (37.5%) were followed up with angiography from 1 to 48 months (mean, 10.4 months). Patients were classified into six categories by using an ischemic ranking profile. Clinical success was defined as a minimum one-category improvement from preprocedure ranking.
The clinical success rate was 98.9% immediately after the procedure and 86.2% at 48 months. Long-term success was statistically more common in patients with higher preprocedure and lower postprocedure ischemic ranking, and in patients without diabetes. Arteriography demonstrated a primary patency rate of 87.5% at latest follow-up, with five occlusions (12.5%) and only two (5.0%) restenoses. Average stenosis was 17.8% at 6 months and 24.7% at 2 years. Stent restenosis was statistically more common with a higher postprocedure pressure gradient. The complication rate was 9.7%, and 30-day mortality was 1.2%.
Long-term clinical and angiographic follow-up demonstrates iliac artery stent placement with the Palmaz stent is safe and efficacious for treatment of limb ischemia.
评估使用帕尔马兹支架进行髂动脉支架置入术治疗肢体缺血的长期疗效。
对83例患者的108条肢体进行了用于治疗肢体缺血的髂动脉支架置入术。80例患者（96.4%）接受了1至70个月（平均25.8个月）的临床随访，30例患者（37.5%）接受了1至48个月（平均10.4个月）的血管造影随访。采用缺血分级量表将患者分为六类。临床成功定义为与术前分级相比至少改善一个等级。
术后即刻临床成功率为98.9%，48个月时为86.2%。从统计学上看，术前缺血分级较高且术后缺血分级较低的患者以及无糖尿病患者长期成功率更高。血管造影显示，在最近一次随访时，原发性通畅率为87.5%，有5例闭塞（12.5%），仅2例（5.0%）再狭窄。6个月时平均狭窄率为17.8%，2年时为24.7%。从统计学上看，术后压力梯度较高时支架再狭窄更常见。并发症发生率为9.7%，30天死亡率为1.2%。
长期临床和血管造影随访表明，使用帕尔马兹支架进行髂动脉支架置入术治疗肢体缺血安全有效。
