Varty K, Nydahl S, Nasim A, Bolia A, Bell P R, London J M
Department of Surgery, Leicester Royal Infirmary, U.K.
Eur J Vasc Endovasc Surg. 1998 Aug;16(2):159-63. doi: 10.1016/s1078-5884(98)80159-7.
To aims of this study was to assess and compare the efficacy of PTA and surgery in the treatment of severe lower limb ischaemia.
Prospective 12-month study of 180 consecutive patients with severe chronic lower limb ischaemia.
PTA was used as first line therapy whenever possible and appropriate. Surgical revascularisation, primary amputation and conservative therapy were used in eh remaining patients. Patient survival and limb salvage were derived using life table analysis.
Revascularisation was attempted in 135 (75%) patients, with PTA in 82 (46%), surgery in 19 (27%) and a combination of both in four (2%). Overall 12-month survival and limb salvage was 75% and 71%, respectively. Surgery and PTA had significantly higher survival rates (91% and 78%) than primary amputation or conservative therapy (57% and 52%) (p < 0.0001 log rank test). Revascularisation with either surgery or PTA achieved the same limb salvage rate of 76%.
A large proportion of patients with severe chronic lower limb ischaemia can be managed by PTA. THis management strategy produces a clinically effective outcome at 1-year.
本研究旨在评估和比较经皮腔内血管成形术（PTA）和手术治疗严重下肢缺血的疗效。
对180例连续性严重慢性下肢缺血患者进行为期12个月的前瞻性研究。
尽可能且适当地将PTA用作一线治疗。其余患者采用手术血管重建、一期截肢和保守治疗。采用生命表分析得出患者生存率和肢体挽救率。
135例（75%）患者尝试进行血管重建，其中82例（46%）采用PTA，19例（27%）采用手术，4例（2%）采用两者联合。总体12个月生存率和肢体挽救率分别为75%和71%。手术和PTA的生存率（91%和78%）显著高于一期截肢或保守治疗（57%和52%）（对数秩检验，p<0.0001）。手术或PTA进行血管重建的肢体挽救率相同，均为76%。
大部分严重慢性下肢缺血患者可通过PTA治疗。这种治疗策略在1年时产生了临床有效结果。
