Ballard J L, Sparks S R, Taylor F C, Bergan J J, Smith D C, Bunt T J, Killeen J D
Division of Vascular Surgery, Loma Linda University Medical Center, CA 92354, USA.
J Vasc Surg. 1996 Oct;24(4):545-53; discussion 553-5. doi: 10.1016/s0741-5214(96)70070-8.
This study was performed to determine the primary patency, foot salvage, and complication rates associated with iliac artery stent deployment.
From March 1992 to May 1995, 147 iliac artery stents were deployed in 98 limbs of 72 patients for disabling claudication or limb-threatening ischemia. Procedure-related and late (> 30 days) complications, as well as adjunctive maneuvers required to correct a complication, were tabulated. Stented iliac artery cumulative primary patency and foot salvage rates were calculated with life-table analysis. Factors that impacted early complications, late complications, foot salvage rates, and stented iliac artery primary patency rates were identified with stepwise logistic regression analysis.
A procedure-related complication occurred in 19 (19.4%) limbs. Initial technical success, however, was achieved in all but three of 98 limbs (96.9%). Stented iliac artery cumulative primary patency rates were 87.6%, 61.9%, 55.3%, and foot salvage rates were 97.7%, 85.1%, 76.1%, at 12, 18, and 24 months, respectively. External iliac artery stent deployment, superficial femoral artery occlusion before treatment, and single-vessel tibial runoff before treatment negatively affected stented iliac artery cumulative primary patency rates. Stented iliac artery primary patency rates were not significantly affected by age, smoking, coronary artery disease, diabetes, hypercholesterolemia, hypertension, presenting symptom, early complication, number of stents deployed, type of stent deployed, or stent deployment for stenosis versus occlusion.
Limb-threatening and life-threatening complications can be associated with iliac artery stent deployment. Stented iliac artery primary patency rates are affected by distal atherosclerotic occlusive disease and the position of the deployed stent within the iliac system. Stent reconstruction of severe iliac artery occlusive disease is feasible but should be thoughtfully selected.
本研究旨在确定与髂动脉支架置入相关的初始通畅率、足部挽救率及并发症发生率。
1992年3月至1995年5月，对72例患者的98条肢体置入147枚髂动脉支架，用于治疗致残性跛行或肢体威胁性缺血。将与手术相关的及晚期（>30天）并发症，以及纠正并发症所需的辅助操作制成表格。采用寿命表分析法计算髂动脉支架置入后的累积初始通畅率和足部挽救率。通过逐步逻辑回归分析确定影响早期并发症、晚期并发症、足部挽救率及髂动脉支架置入后初始通畅率的因素。
19条（19.4%）肢体出现与手术相关的并发症。然而，98条肢体中除3条外其余均取得了初始技术成功（96.9%）。髂动脉支架置入后的累积初始通畅率在12个月、18个月和24个月时分别为87.6%、61.9%、55.3%，足部挽救率分别为97.7%、85.1%、76.1%。髂外动脉支架置入、治疗前股浅动脉闭塞以及治疗前单支胫动脉血流对髂动脉支架置入后的累积初始通畅率产生负面影响。髂动脉支架置入后的初始通畅率不受年龄、吸烟、冠状动脉疾病、糖尿病、高胆固醇血症、高血压、就诊症状、早期并发症、置入支架数量、置入支架类型或因狭窄与闭塞而行的支架置入的显著影响。
髂动脉支架置入可能会出现肢体威胁性和生命威胁性并发症。髂动脉支架置入后的初始通畅率受远端动脉粥样硬化闭塞性疾病及置入支架在髂动脉系统中的位置影响。严重髂动脉闭塞性疾病的支架重建可行，但应谨慎选择。
