Colyer W R, Moore J A, Burket M W, Cooper C J
Cardiology Division, Medical College of Ohio, Toledo 43699-0008, USA.
Cathet Cardiovasc Diagn. 1997 Sep;42(1):1-6. doi: 10.1002/(sici)1097-0304(199709)42:1<1::aid-ccd1>3.0.co;2-8.
Severe aortoiliac peripheral vascular disease (PVD) is considered a contraindication for the placement of an intraaortic balloon pump (IABP) because of a high risk of limb ischemia. Recent advances in percutaneous transluminal angioplasty (PTA) and stenting have altered the treatment of iliac stenoses such that the results of PTA with stenting compare favorably with surgery. We reviewed our experience with placement of IABP between July 1994 and February 1996. Of 64 patients receiving IABP, 17 had known or suspected peripheral vascular disease. Severe iliac or distal aortic stenoses were present in 9. These 9 patients underwent PTA with or without stenting prior to 10 IABP insertions. Limb ischemia occurred in 10% of PVD patients treated with percutaneous revascularization, compared to 11% in patients without PVD. No patient had a serious vascular complication or required vascular surgery. We conclude that percutaneous revascularization in patients with severe aortoiliac PVD, for whom this IABP insertion had previously been considered contraindicated, results in a low rate of limb ischemia.
严重的主髂动脉周围血管疾病（PVD）被视为主动脉内球囊反搏泵（IABP）置入的禁忌症，因为存在肢体缺血的高风险。经皮腔内血管成形术（PTA）和支架置入术的最新进展改变了髂动脉狭窄的治疗方式，使得PTA联合支架置入术的效果可与手术相媲美。我们回顾了1994年7月至1996年2月期间IABP置入的经验。在64例接受IABP的患者中，17例已知或怀疑患有周围血管疾病。其中9例存在严重的髂动脉或主动脉远端狭窄。这9例患者在10次IABP置入术前接受了有或无支架置入的PTA。接受经皮血管重建术治疗的PVD患者中，10%发生了肢体缺血，而无PVD患者为11%。没有患者发生严重的血管并发症或需要进行血管手术。我们得出结论，对于先前被认为IABP置入术为禁忌症的严重主髂动脉PVD患者，经皮血管重建术导致肢体缺血的发生率较低。
