Murakami R, Korogi Y, Hirai T, Hamatake S, Ikushima I, Takahashi M
Department of Radiology, Kumamoto University School of Medicine, Japan.
Radiat Med. 1998 Jan-Feb;16(1):25-30.
To evaluate the initial and long-term results of percutaneous transluminal angioplasty (PTA) for totally occluded iliac arteries.
Fifty-four occluded iliac arteries in 54 patients were treated by PTA. The mean length of the occlusions was 8.0 cm (range 0.5-24.0 cm). Patients were followed for a maximum of 124 months (mean, 56 months).
The initial success rate was 57% (31 of 54). On follow-up study, two arteries were reoccluded, and six showed evidence of restenosis. These recurrences were observed within 20 months after PTA. The long-term results obtained by Kaplan-Meier life-table analysis revealed a 71% primary patency rate and 93% secondary patency rate for 124 months. Thirteen arteries were treated by surgical intervention, while the other arteries with unsuccessful PTA were followed conservatively because of a high risk for surgery or patients' refusal to have surgery. Major complications were recorded in 7% (4 of 54) of cases: thrombosis requiring emergent bypass surgery in one artery, and distal embolization requiring thromboembolectomy in three.
Although the procedure is difficult, the long-term results suggest that PTA is an effective method and a treatment of choice for totally occluded iliac arteries.
评估经皮腔内血管成形术（PTA）治疗髂动脉完全闭塞的初始及长期效果。
54例患者的54条闭塞髂动脉接受了PTA治疗。闭塞段平均长度为8.0厘米（范围0.5 - 24.0厘米）。患者随访时间最长为124个月（平均56个月）。
初始成功率为57%（54例中的31例）。随访研究发现，两条动脉再次闭塞，六条有再狭窄迹象。这些复发情况在PTA术后20个月内出现。通过Kaplan - Meier生存表分析得出的长期结果显示，124个月时的一期通畅率为71%，二期通畅率为93%。13条动脉接受了手术干预，而其他PTA治疗失败的动脉因手术风险高或患者拒绝手术而采取保守随访。7%（54例中的4例）的病例记录有严重并发症：一条动脉发生血栓形成需紧急行搭桥手术，三条动脉发生远端栓塞需行血栓切除术。
尽管该手术操作困难，但长期结果表明PTA是治疗髂动脉完全闭塞的一种有效方法且是首选治疗手段。
