专题研究(Monographic Study)

介入手术治疗复杂主髂动脉闭塞症:附16例分析

Published at: 2016年第25卷第6期

葛世堂 1 , 任美健 2 , 张希全 1 , 任可伟 1
1 中国人民解放军第一四八中心医院 全军腔内介入诊疗中心,山东 淄博 255300
2 潍坊医学院,山东 潍坊 261042
通讯作者 希全 张 Email: zyfbb19901024@sina.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.06.012
基金:

摘要

目的:探讨经皮腔内介入治疗复杂主髂动脉闭塞症的临床疗效。方法:回顾性分析收治的16例复杂主髂动脉闭塞患者临床资料,患者均行介入手术治疗,通过多穿刺入路途径,采用内膜下血管再通技术和导丝抓捕技术建立工作导丝通道,然后行球囊扩张术及对吻技术支架植入等。结果:16例复杂主髂动脉闭塞的患者,手术均获得成功,手术成功率100%。16例患者中15例患者血管完全通畅,症状明显改善,1例患者症状中度改善,下肢缺血症状消失。1例患者出现穿刺部位血肿,术后并发症发生率为6.25%。所有患者均随访3~48个月,其中有5例患者出现支架内狭窄及血栓形成,经过腔内介入治疗后再次恢复血流。术后12、24、36个月血管通畅率分别为87.5%、81.25%、68.75%。结论:经皮腔内介入治疗复杂主髂动脉闭塞,能够迅速打通血管、恢复血流,且并发症少,临床效果满意。


Clinical efficacy of interventional therapy for complex aortoiliac arterial occlusion

Abstract

Objective: To investigate the clinical efficacy of percutaneous interventional treatment for complex aortoiliac arterial occlusion. Methods: The clinical data of 16 patients with complex aortoiliac arterial occlusion were retrospectively analyzed. All patients underwent interventional procedures by using subintimal recanalization technique and catheter-capture technique to establish a working guidewire channel via multi-puncture approach, and then underwent balloon dilatation and kissing stent placement. Results: Operation was performed successfully in all the 16 patients with complex aortoiliac arterial occlusion, and the surgical success rate was 100%. Among them, blood flow was completely restored and symptoms were improved significantly in 15 cases, and symptoms were moderately improved in 1 case, in whom the symptoms of lower limb ischemia disappeared. Puncture-site hematoma occurred in one case, and the incidence of postoperative complications was 6.25%. All patients were followed up for 3 to 48 months. Intra-stent stenosis or thrombosis occurred in 5 cases, and blood flow was restored after a second endovascular intervention. The 12-, 24- and 36-month patency rate was 87.5%, 81.25% and 68.75% respectively. Conclusion: For complex aortoiliac arterial occlusion, percutaneous interventional treatment can rapidly recanalize the occlusion and restore the blood flow with low incidence of complications, so it has satisfactory clinical efficacy.


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引用

引用本文: 世堂 葛, 美健 任, 希全 张, 可伟 任. 介入手术治疗复杂主髂动脉闭塞症:附16例分析[J]. 中国普通外科杂志, 2016, 25(6): 848-852.
Cite this article as: GE Shitang, REN Meijian, ZHANG Xiquan, REN Kewei . Clinical efficacy of interventional therapy for complex aortoiliac arterial occlusion[J]. Chin J Gen Surg, 2016, 25(6): 848-852.