Westcott M A, Bonn J
Thomas Jefferson University Hospital, Division of Cardiovascular and Interventional Radiology, Philadelphia, Pennsylvania, USA.
J Vasc Interv Radiol. 1998 Mar-Apr;9(2):225-31. doi: 10.1016/s1051-0443(98)70261-1.
To retrospectively compare the safety and short-term efficacy of conventional percutaneous transluminal angioplasty (PTA) and PTA with the Palmaz balloon-expandable intravascular stent for the treatment of infrarenal abdominal aortic atherosclerotic stenoses.
The records of 25 patients with infrarenal aortic stenoses treated by means of percutaneous techniques were retrieved from the SCVIR Transluminal Angioplasty and Revascularization (STAR) Registry and analyzed. Thirteen patients were treated with PTA alone and 12 were treated with the Palmaz intravascular stent.
Technical success was achieved in 92% of patients treated with PTA alone and in 100% of those treated with the Palmaz stent. Significant improvements in lesion morphology, hemodynamics, clinical status, and ankle arm indexes were shown in both groups. There was no statistically significant difference in percent stenosis reduction, decrease in trans-stenotic gradient, or initial clinical outcome between the group treated by means of PTA and the group treated by means of PTA with the Palmaz stent.
PTA and intravascular stent placement of atherosclerotic stenoses involving the infrarenal aorta are both safe and efficacious therapeutic modalities. At present, it does not appear that primary stent placement confers any short-term benefits over technically successful PTA in aortic stenoses.
回顾性比较传统经皮腔内血管成形术(PTA)与使用帕尔马兹球囊可扩张血管内支架的PTA治疗肾下腹主动脉粥样硬化狭窄的安全性和短期疗效。
从SCVIR腔内血管成形术和血管重建(STAR)登记处检索并分析了25例采用经皮技术治疗的肾下主动脉狭窄患者的记录。13例患者仅接受PTA治疗,12例患者接受帕尔马兹血管内支架治疗。
仅接受PTA治疗的患者中有92%取得技术成功,接受帕尔马兹支架治疗的患者中这一比例为100%。两组患者的病变形态、血流动力学、临床状况和踝臂指数均有显著改善。PTA治疗组与使用帕尔马兹支架的PTA治疗组在狭窄程度降低百分比、跨狭窄梯度降低或初始临床结果方面无统计学显著差异。
PTA和对累及肾下腹主动脉的粥样硬化狭窄进行血管内支架置入都是安全有效的治疗方式。目前,在主动脉狭窄方面,初次支架置入似乎并未比技术成功的PTA带来任何短期益处。