Blum U, Gabelmann A, Redecker M, Nöldge G, Dornberg W, Grosser G, Heiss W, Langer M
Department of Diagnostic Radiology, University Hospital Freiburg, Germany.
Radiology. 1993 Nov;189(2):536-40. doi: 10.1148/radiology.189.2.8210387.
To evaluate the long-term results of recanalization of occluded iliac arteries with local low-dose thrombolysis, angioplasty, and, if necessary, stent implantation.
Forty-seven patients with acute or chronic occlusions of the common or external iliac artery, or both, underwent local low-dose thrombolysis (n = 47), percutaneous transluminal angioplasty (PTA) (with balloon dilation [n = 43] and rotational angioplasty [n = 30] in the patients in whom a retrograde recanalization was performed), and, if needed, intravascular stent placement (n = 18). Follow-up lasted 3-53 (mean, 21) months.
The primary recanalization rate was 98% (46 of 47). The mean ankle-brachial index increased from 0.33 to 0.81 within 14 days after treatment and was 0.76 at the most recent follow-up. Two early (< 14 days) and two late reocclusions (after 24 and 30 months) occurred; one restenosis detected with duplex sonography and angiography was observed after 19 months.
This therapy represents a true alternative to vascular surgery and a first-line treatment for acute or chronically occluded iliac arteries.
评估局部低剂量溶栓、血管成形术以及必要时支架植入术对闭塞性髂动脉再通的长期效果。
47例髂总动脉或髂外动脉急性或慢性闭塞患者,或两者均有闭塞,接受了局部低剂量溶栓(n = 47)、经皮腔内血管成形术(PTA)(对进行逆行再通的患者采用球囊扩张术[n = 43]和旋切血管成形术[n = 30]),必要时进行血管内支架置入(n = 18)。随访持续3 - 53个月(平均21个月)。
初次再通率为98%(47例中的46例)。治疗后14天内,平均踝肱指数从0.33升至0.81,最近一次随访时为0.76。发生了2例早期(< 14天)和2例晚期再闭塞(分别在24个月和30个月后);19个月后通过双功超声和血管造影检测到1例再狭窄。
该治疗方法是血管外科手术的一种切实可行的替代方案,也是急性或慢性闭塞性髂动脉的一线治疗方法。