Whyman M R, Ruckley C V, Fowkes F G
Wolfson Unit for Prevention of Peripheral Vascular Diseases, Medical School, Edinburgh, UK.
Eur J Vasc Surg. 1993 Jul;7(4):444-7. doi: 10.1016/s0950-821x(05)80264-6.
A foreknowledge of impending femoral artery occlusion might allow prevention of a deterioration in ischaemia by percutaneous transluminal angioplasty (PTA) in the preocclusive stage. A window of opportunity exists before a femoral stenosis progresses to occlusion and its treatment by PTA becomes more difficult, riskier and associated with lower patency. The size of this window is unknown. This is the first report of a study of the natural history of femoral stenoses using Duplex ultrasound. The aims of the study were to determine in patients with symptomatic peripheral arterial disease: (1) the incidence of progression from stenosis to occlusion; (2) the change in severity of stenosis over time; and (3) the relationship between severity of stenosis and progression to occlusion. The velocity ratio (VR) of 43 femoral artery stenoses in 38 patients was measured by Duplex ultrasound. The examination was repeated after a median of 28 (range 5-76) weeks. Nine/43 (21%) stenoses progressed to occlusion within a median of 13 weeks. Little overall change in VR was demonstrable if occlusion did not occur. Only stenoses with a VR > 3 progressed to occlusion in the study period. The data suggest that severe stenoses progress more rapidly than moderate, with a relatively brief window of opportunity. If PTA is to be undertaken, stenoses with a VR greater than 3 should be treated with minimum delay.
对即将发生的股动脉闭塞的预先了解，可能有助于在闭塞前期通过经皮腔内血管成形术（PTA）预防缺血情况恶化。在股动脉狭窄进展至闭塞且通过PTA进行治疗变得更加困难、风险更高且通畅率更低之前，存在一个机会窗口。这个窗口的大小尚不清楚。这是首篇利用双功超声研究股动脉狭窄自然病程的报告。该研究的目的是确定有症状的外周动脉疾病患者：（1）从狭窄进展至闭塞的发生率；（2）狭窄严重程度随时间的变化；以及（3）狭窄严重程度与进展至闭塞之间的关系。通过双功超声测量了38例患者43处股动脉狭窄的速度比（VR）。在中位时间28周（范围5 - 76周）后重复检查。43处狭窄中有9处（21%）在中位时间13周内进展至闭塞。如果未发生闭塞，VR总体变化不大。在研究期间，只有VR > 3的狭窄进展至闭塞。数据表明，严重狭窄比中度狭窄进展更快，机会窗口相对较短。如果要进行PTA，VR大于3的狭窄应尽快治疗。
