Martinez R, Rodriguez-Lopez J, Diethrich E B
Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute, Phoenix 85006, USA.
Tex Heart Inst J. 1997;24(1):15-22.
We report the long-term results of abdominal aortic stenting in 24 patients who underwent stenting for atherosclerotic occlusive disease (16 stenoses, 6 occlusions, and 2 ulcerative plaques). The occlusions were treated initially with thrombolytic therapy, and all lesions were balloon dilated. Indications for stenting were: residual gradient (n = 10); recoil (n = 7); dissection (n = 2); and atherosclerotic debris (n = 5). Thirty-eight Palmaz stents were implanted in the aorta, and 21 were implanted in the common iliac (n = 19) and external iliac (n = 2) arteries. Technical and clinical success was 100%. Over a mean follow-up period of 48 months (range, 1 to 67 months), 2 patients died and 2 were lost to follow-up. Two patients developed symptoms referable to the aorta (at 43 and 67 months), and each was managed successfully via an endovascular approach. There was no in-stent restenosis. Life-table analysis showed a 100% cumulative primary patency at 5 years. We conclude that stenting for abdominal aortic occlusive disease appears to offer long-term patency slightly superior to that of classical surgical intervention. Aortic stents also do not appear to be subject to restenosis. Follow-up in a larger patient cohort is needed to confirm these observations.
我们报告了24例因动脉粥样硬化闭塞性疾病(16例狭窄、6例闭塞和2例溃疡性斑块)接受支架置入术的患者的腹主动脉支架置入长期结果。闭塞病变最初采用溶栓治疗,所有病变均行球囊扩张。支架置入的指征为:残余压差(n = 10);弹性回缩(n = 7);夹层(n = 2);以及动脉粥样硬化碎片(n = 5)。共在主动脉植入38枚帕尔马兹支架,在髂总动脉(n = 19)和髂外动脉(n = 2)植入21枚。技术成功率和临床成功率均为100%。平均随访48个月(范围1至67个月),2例患者死亡,2例失访。2例患者(分别在43个月和67个月时)出现与主动脉相关的症状,均通过血管内介入方法成功处理。无支架内再狭窄。生存分析显示5年累积原发性通畅率为100%。我们得出结论,腹主动脉闭塞性疾病的支架置入术似乎能提供略优于传统外科手术干预的长期通畅率。主动脉支架似乎也不易发生再狭窄。需要在更大的患者队列中进行随访以证实这些观察结果。