Scheinert D, Ragg J C, Vogt A, Böttcher H, Steinkamp H, Biamino G
Medizinische Klinik mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Medizinische Fakultät, Humboldt-Universität, Berlin.
Rofo. 1998 Sep;169(3):302-9. doi: 10.1055/s-2007-1015094.
The objective of this study was to analyze the primary and long-term results of implanting self-expanding covered nitinol stents (EndoPro I) in iliac arteries.
A total of 48 EndoPro (length 8.3 +/- 4.2 cm) were implanted in 39 patients. In 22 cases (group A) the implantation was performed after excimer laser-assisted recanalization (PTLA) of long iliac occlusions (mean 9.8 +/- 3.9 cm). Other indications were aneurysmatic lesions (n = 16) and one arterial perforation (group B).
In 21 of 22 patients of group A the patency of the blood vessel was successfully restored. In all cases of group B the aneurysmatic lesions were finally excluded. This was correlated with a clinical improvement of at least one grade (Rutherford criteria) in 86.4% of patients (group A). The primary patency rate based on clinical examination (treadmill test) and color-coded Doppler was evaluated at 6 (89.7%), 12 (87.1%), and 24 (84.2%) months follows up, respectively. Subacute thromboses occurred in two, relevant restenoses in three cases (group A). In three of these 5 cases the vessel segment was successfully reopened by PTLA or rt-PA thrombolysis, leading to secondary patency rates of 94.9% at 6 and 92.1% at 12 and 24 months, respectively.
In cases of relevant dissection following PTLA of long pelvic artery occlusions implantation of covered stents is effective to stabilize the results. Furthermore, the device is well applicable to seal arterial ruptures or aneurysms.
本研究的目的是分析在髂动脉中植入自膨式覆膜镍钛诺支架（EndoPro I）的主要及长期结果。
39例患者共植入48枚EndoPro支架（长度8.3±4.2 cm）。22例（A组）在准分子激光辅助再通（PTLA）长段髂动脉闭塞（平均9.8±3.9 cm）后进行植入。其他适应证为动脉瘤性病变（n = 16）和1例动脉穿孔（B组）。
A组22例患者中有21例血管通畅成功恢复。B组所有病例的动脉瘤性病变最终均被排除。这与86.4%的患者（A组）临床改善至少1级（卢瑟福标准）相关。分别在随访6个月（89.7%）、12个月（87.1%）和24个月（84.2%）时，根据临床检查（平板运动试验）和彩色编码多普勒评估主要通畅率。发生亚急性血栓形成2例，3例发生相关再狭窄（A组）。在这5例中的3例中，血管段通过PTLA或rt-PA溶栓成功重新开通，导致6个月时的继发通畅率为94.9%，12个月和24个月时分别为92.1%。
在长段盆腔动脉闭塞PTLA后出现相关夹层的情况下，植入覆膜支架可有效稳定结果。此外，该装置适用于封闭动脉破裂或动脉瘤。
