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[经皮腔内髂动脉闭塞血管成形术]

[Percutaneous transluminal angioplasty of iliac occlusions].

作者信息

Vogt K C, Just S R, Levi-Mazloum N D, Grønvall Rasmussen J B, Lorentzen J E, Schroeder T V

机构信息

Karkirurgisk Afdeling, Rigshospitalet, København.

出版信息

Ugeskr Laeger. 1995 May 22;157(21):3042-5.

PMID:7792957
Abstract

Percutaneous transluminal angioplasty (PTA) has become an established treatment modality for iliac artery stenosis. PTA of iliac artery occlusions, however, remains a topic of controversy due to difficulties with mechanical recanalization, a lower patency rate and a higher complication rate than obtained after PTA of iliac artery stenosis. During a three year period, we performed 31 PTA's of iliac artery occlusions. The primary recanalization rate was 71% (22 occlusions). Stents were applied in 16 patients. The cumulated patency rates were 95% and 85% after one and six months respectively. There was one late reocclusion after two years. We found a tendency towards inferior patency in the longer occlusions (> or = 5cm). The complication rate was 10% due to three episodes of distal embolisation, all of which were successfully treated immediately with additional PTA and stenting. These results are in accordance with the results of international studies, and suggest that PTA is a useful alternative to surgical treatment of iliac artery occlusions, albeit long occlusions involving both the common and the external iliac artery should be excluded.

摘要

经皮腔内血管成形术(PTA)已成为治疗髂动脉狭窄的既定治疗方式。然而,由于机械再通困难、通畅率低于髂动脉狭窄PTA术后且并发症发生率更高,髂动脉闭塞的PTA仍然是一个有争议的话题。在三年期间,我们对31例髂动脉闭塞患者进行了PTA。初次再通率为71%(22例闭塞)。16例患者应用了支架。术后1个月和6个月的累积通畅率分别为95%和85%。两年后有1例晚期再闭塞。我们发现较长闭塞(≥5cm)的通畅率有降低趋势。并发症发生率为10%,原因是3次远端栓塞,所有这些均通过额外的PTA和支架置入立即成功治疗。这些结果与国际研究结果一致,表明PTA是髂动脉闭塞手术治疗的一种有用替代方法,尽管应排除累及髂总动脉和髂外动脉的长段闭塞。

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