Wack C, Wölfle K D, Loeprecht H, Tietze W, Bohndorf K
Klinik für Gefäss- und Thoraxchirurgie, Zentralklinikum Augsburg.
Vasa. 1994;23(1):30-4.
Between 1990 and 1993 we performed 42 percutaneous transluminal balloon angioplasties (PTA) in 30 patients with isolated lesions of crural arteries and limb threatening ischaemia. The average age of the patients was 70.5 years, 90% were diabetics. With low-profile balloon catheters between 2 and 4 mm we dilatated 15 tibioperoneal trunks, 12 anterior tibial arteries, 3 posterior tibial arteries and 12 peroneal arteries. Initial success was achieved in 83% of the dilatations with an average increase of ankle-brachial index of 0.18. After PTA two groin haematomes as the only complications were observed. In 22 cases healing of the acral lesions under local surgical treatment was seen. Two of the clinical unsuccessful patients required popliteopedal bypass surgery and 5 below-knee amputation because of lacking reconstructive possibilities. The follow-up period varied from 1 to 35 months (mean 10.3 months). Life table analysis showed a cumulative limb salvage rate of 82% after one and two years. The PTA of infrapopliteal artery stenoses and occlusions is considered as an effective and safe therapy modality to avoid below-knee amputation in patients with limb threatening ischaemia.
1990年至1993年间，我们对30例患有小腿动脉孤立性病变且肢体存在缺血风险的患者进行了42次经皮腔内血管成形术（PTA）。患者的平均年龄为70.5岁，其中90%为糖尿病患者。我们使用2至4毫米的薄壁球囊导管，对15条胫腓干、12条胫前动脉、3条胫后动脉和12条腓动脉进行了扩张。83%的扩张取得了初步成功，踝肱指数平均增加了0.18。PTA术后仅观察到两例腹股沟血肿并发症。22例患者经局部手术治疗后足部病变愈合。2例临床治疗失败的患者因缺乏重建可能性而需要腘动脉-足背动脉搭桥手术，5例患者需要进行膝下截肢。随访期为1至35个月（平均10.3个月）。生命表分析显示，1年和2年后的累计肢体挽救率为82%。对于有肢体缺血风险的患者，腘动脉以下动脉狭窄和闭塞的PTA被认为是一种有效且安全的治疗方式，可避免膝下截肢。
