经皮腔内血管成形术后髂动脉狭窄：双功超声随访

Iliac artery stenoses after percutaneous transluminal angioplasty: follow-up with duplex ultrasonography.

作者信息

Spijkerboer A M, Nass P C, de Valois J C, Eikelboom B C, Overtoom T T, Beek F J, Moll F L, Mali W P

机构信息

Department of Radiology, University Hospital, Utrecht, The Netherlands.

出版信息

J Vasc Surg. 1996 Apr;23(4):691-7. doi: 10.1016/s0741-5214(96)80051-6.

DOI:10.1016/s0741-5214(96)80051-6

PMID:8627907

Abstract

PURPOSE

To assess iliac artery stenosis before and up to 1 year after percutaneous transluminal angioplasty (PTA) with duplex ultrasound (DUS) to determine the incidence of residual and recurrent stenoses and correlate these findings to clinical outcome.

PATIENTS AND METHODS

Sixty-one patients with 70 iliac artery segments treated with PTA were examined. The peak systolic velocity (PSV) ratio (PSV ratio = PSV in stenosis divided by PSV proximal or distal to stenosis) was determined by DUS before PTA and 1 day, 3 months and 1 year after PTA. Three categories of results were identified by using PSV ratios at the site of the treated stenosis 1 day and 1 year after PTA (good result, residual stenosis, and recurrent stenosis). The DUS-determined anatomic result was correlated with the clinical outcome at 1 year. Clinical outcome was classified according to Society for Vascular Surgery/International Society for Cardiovascular Surgery (SVS/ISCVS) criteria.

RESULTS

Good results with DUS (PSV ratio 1 day and 1 year after PTA > or = to 2.5) were found in 45 of 70 segments (64.3%), residual stenoses (PSV ratio > or .5 1 day after PTA) in 15 of 70 segments (21.4%), and recurrent stenosis (PSV ratio 1 day after PTA < 2.5 and 1 year after PTA > or = 2.5) in 10 of 70 segments (14.3%). PSV ratios of residual stenoses decreased significantly between 1 day and 1 year after PTA because some residual stenoses improved hemodynamically in time. Clinical results were significantly better in patients with a good result compared with other patients. However, the clinical outcome of patients with residual stenoses was not significantly different from the patients with good DUS results.

CONCLUSION

Some residual stenoses improved sonographically after PTA. Clinical results at 1 year are highly variable within different groups. Clinical outcome of patients with residual stenoses did not differ from patients with good DUS results, whereas clinical outcome in patients with recurrent stenoses was worse than in the other groups.

摘要

目的

采用双功超声（DUS）评估经皮腔内血管成形术（PTA）术前及术后长达1年的髂动脉狭窄情况，以确定残余狭窄和再发狭窄的发生率，并将这些结果与临床结局相关联。

患者与方法

对61例接受PTA治疗的70处髂动脉节段的患者进行检查。通过DUS在PTA术前、术后1天、3个月和1年测定收缩期峰值流速（PSV）比值（PSV比值 = 狭窄处的PSV除以狭窄近端或远端的PSV）。根据PTA术后1天和1年时治疗狭窄部位的PSV比值确定三类结果（良好结果、残余狭窄和再发狭窄）。将DUS确定的解剖学结果与1年时的临床结局相关联。临床结局根据血管外科学会/国际心血管外科学会（SVS/ISCVS）标准进行分类。

结果

70处节段中的45处（64.3%）DUS结果良好（PTA术后1天和1年的PSV比值≥2.5），70处节段中的15处（21.4%）存在残余狭窄（PTA术后1天的PSV比值＞或.5），70处节段中的10处（14.3%）存在再发狭窄（PTA术后1天的PSV比值＜2.5且PTA术后1年的PSV比值≥2.5）。残余狭窄的PSV比值在PTA术后1天至1年之间显著下降，因为一些残余狭窄在血流动力学上随时间有所改善。与其他患者相比，结果良好的患者临床结果明显更好。然而，残余狭窄患者的临床结局与DUS结果良好的患者并无显著差异。