van Lankeren W, Gussenhoven E J, van der Lugt A, Vischjager M, Khajehi P, Pieterman H, Gerritsen P G
University Hospital Rotterdam-Dijkzigt, The Netherlands.
AJR Am J Roentgenol. 1996 Jun;166(6):1355-60. doi: 10.2214/ajr.166.6.8633447.
The purpose of this study was to establish the arterial responses of the iliac artery after percutaneous transluminal angioplasty (PTA), using intravascular sonography, and to correlate intravascular sonography parameters with clinical outcome.
The study included 21 patients studied with intravascular sonography before and after PTA of the iliac artery. Distinction was made between intravascular sonography cross sections collected from the common iliac and those from the external iliac artery. First, qualitative and quantitative intravascular sonography data obtained at the most stenotic site were compared with data derived from all corresponding cross sections of the dilated segment. Second, the predictive value of intravascular sonography parameters for the patient outcome was assessed.
The free lumen and media-bounded areas seen in the common iliac artery were larger than those seen in the external iliac artery. Qualitative and quantitative effects of PTA observed with intravascular sonography on the two types of artery were not different. Vascular damage occurred in 81% of the patients. The frequency of vascular damage at the most stenotic site was slightly lower than in each dilated segment studied. The reduction in area stenosis after intervention was associated with an increase in the free lumen and media-bounded areas, whereas the plaque area reduced only slightly. The increase in the free lumen and media-bounded areas and the decrease in the plaque area at the most stenotic site after intervention were larger than the mean values. Qualitative data seen with intravascular sonography at the most stenotic site before and after intervention were not predictive of the patient outcome. In patients with an uneventful outcome after intervention, the free lumen area measured at the most stenotic site after PTA was larger and the area stenosis was smaller than in patients with a failure.
This study of intravascular sonography established that although the common iliac artery is larger than the external iliac artery, the qualitative and quantitative effects of PTA in both types of artery were similar. The size of the free lumen area and the degree of stenosis seen with intravascular sonography after PTA at the most stenotic site may be predictive of a patient outcome.
本研究旨在使用血管内超声检查确定经皮腔内血管成形术（PTA）后髂动脉的动脉反应，并将血管内超声参数与临床结果相关联。
本研究纳入了21例在髂动脉PTA前后接受血管内超声检查的患者。区分了从髂总动脉和髂外动脉采集的血管内超声横截面。首先，将在最狭窄部位获得的定性和定量血管内超声数据与从扩张段的所有相应横截面获得的数据进行比较。其次，评估血管内超声参数对患者结局的预测价值。
髂总动脉中的自由管腔和中膜边界面积大于髂外动脉中的。血管内超声观察到的PTA对两种类型动脉的定性和定量影响无差异。81%的患者发生了血管损伤。最狭窄部位的血管损伤频率略低于所研究的每个扩张段。干预后狭窄面积的减小与自由管腔和中膜边界面积的增加相关，而斑块面积仅略有减小。干预后最狭窄部位自由管腔和中膜边界面积的增加以及斑块面积的减小大于平均值。干预前后在最狭窄部位通过血管内超声观察到的定性数据不能预测患者结局。干预后结局良好的患者，PTA后在最狭窄部位测量的自由管腔面积较大，狭窄面积小于结局不佳的患者。
这项血管内超声研究表明，尽管髂总动脉比髂外动脉大，但PTA对两种类型动脉的定性和定量影响相似。PTA后在最狭窄部位通过血管内超声观察到的自由管腔面积大小和狭窄程度可能预测患者结局。
