Strecker E P, Hagen B, Liermann D, Schneider B, Wolf H R, Wambsganss J
Department of Radiology and Nuclear Medicine, Diakonissenkrankenhaus Rüppurr, Federal Republic of Germany.
Cardiovasc Intervent Radiol. 1993 May-Jun;16(3):158-64. doi: 10.1007/BF02641885.
Two hundred patients were treated with tantalum stents, 2 in the aortoiliac bifurcation, 114 in the iliac, and 84 in the femoropopliteal arteries. The indications for stenting were technically unsuccessful percutaneous transluminal angioplasty (PTA) due to arterial recoil, dissection (156 patients), or acute occlusions (15 patients). Long iliac artery occlusions (29 patients) were indications for primary stenting. Life-table analysis revealed a 3-year patency rate of 95% for stented iliac arteries, and a 1-year patency rate of 80% for stented femoropopliteal arteries. Restenosis of the stented femoropopliteal lumen was particularly frequent in stents placed for restenosis following prior PTA (7 of 12 patients), in stents placed into the distal superficial femoral and popliteal arteries (14 of 24 patients), and in stents positioned over a longer than 4-cm artery segment (9 of 16 patients). For the aortic bifurcation and iliac arteries, arterial stenting has proved to be a valuable adjunct to PTA; for femoropopliteal arteries, stenting should be restricted to acute arterial occlusions or severe residual stenosis following PTA.
200例患者接受了钽支架治疗,其中2例用于主髂动脉分叉处,114例用于髂动脉,84例用于股腘动脉。支架置入的指征是由于动脉回缩、夹层形成(156例患者)或急性闭塞(15例患者)导致经皮腔内血管成形术(PTA)技术失败。长段髂动脉闭塞(29例患者)是一期支架置入的指征。生存分析显示,支架置入的髂动脉3年通畅率为95%,支架置入的股腘动脉1年通畅率为80%。在因先前PTA后再狭窄而置入的支架(12例患者中的7例)、置入股浅动脉远端和腘动脉的支架(24例患者中的14例)以及置入长度超过4 cm动脉段的支架(16例患者中的9例)中,支架置入的股腘动脉管腔再狭窄尤为常见。对于主动脉分叉和髂动脉,动脉支架置入已被证明是PTA的一种有价值的辅助手段;对于股腘动脉,支架置入应仅限于急性动脉闭塞或PTA后严重残余狭窄。