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高安动脉炎:16例胸降主动脉和腹主动脉经皮腔内血管成形术后的初始及长期随访

Takayasu arteritis: initial and long-term follow-up in 16 patients after percutaneous transluminal angioplasty of the descending thoracic and abdominal aorta.

作者信息

Rao S A, Mandalam K R, Rao V R, Gupta A K, Joseph S, Unni M N, Subramanyan R, Neelakandhan K S

机构信息

Department of Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.

出版信息

Radiology. 1993 Oct;189(1):173-9. doi: 10.1148/radiology.189.1.8103942.

Abstract

PURPOSE

To analyze results of percutaneous transluminal angioplasty (PTA) for stenosis of the descending thoracic and/or abdominal aorta caused by Takayasu arteritis (TA).

MATERIALS AND METHODS

Subjects were 16 patients (12 female and four male, aged 6-46 years) with symptoms of hypertension or severe bilateral lower limb claudication. Total aortography revealed stenotic lesions in the descending thoracic aorta in five, in the abdominal aorta in 10, and in both vessels in one patient. Involvement of arch vessels in four patients and of the renal artery in four patients was also noted. Double-balloon angioplasty was performed in eight patients.

RESULTS

Initial technical and clinical success was 100%. The maximum follow-up period was 52 months (mean, 21 months 2 weeks). Ankle-brachial index as determined with Doppler ultrasound improved considerably in 10 patients. Three patients had symptoms of restenosis during follow-up. Cumulative patency rate by life-table analysis was 67%.

CONCLUSION

PTA has a definite role in the management of TA in view of its procedural simplicity, cost-effectiveness, and results compared with surgical revascularization procedures.

摘要

目的

分析经皮腔内血管成形术(PTA)治疗高安动脉炎(TA)所致胸降主动脉和/或腹主动脉狭窄的效果。

材料与方法

研究对象为16例患者(12例女性,4例男性,年龄6 - 46岁),有高血压或严重双侧下肢间歇性跛行症状。全主动脉造影显示,5例患者胸降主动脉有狭窄病变,10例患者腹主动脉有狭窄病变,1例患者两者均有狭窄病变。还发现4例患者的弓状血管受累,4例患者的肾动脉受累。8例患者接受了双球囊血管成形术。

结果

初始技术和临床成功率为100%。最长随访期为52个月(平均21个月2周)。10例患者经多普勒超声测定的踝臂指数有显著改善。3例患者在随访期间出现再狭窄症状。通过寿命表分析得出的累积通畅率为67%。

结论

鉴于PTA操作简单、性价比高,且与手术血管重建术相比效果良好,其在TA的治疗中具有明确作用。

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