【摘要】 目的探讨下肢动脉硬化闭塞性疾病介入治疗方法的选择和临床疗效观测。方法本组53例73处病变(狭窄性48处,闭塞性25处),采用球囊成形、支架成形、腔内旋切和内膜下血管成形等多种介入手段干预、治疗。结果73处病变:单纯球囊成形10例,辅助支架成形20例,均成功;单纯腔内旋切8例,辅助支架成形的14例(19处自膨式支架,1处弹簧式支架),手术失败1例;单纯内膜下血管成形5例,辅助支架成形的11例,手术失败4例。41例临床症状明显改善,20例症状部分缓解,5例疗效欠佳。4例患者因术后缺血再灌注损伤行切开解压后好转,2例因小腿骨筋膜室综合征行膝关节以下离断术。术后平均随访10.5(2~33)个月,2例术后6个月症状复发未予以进一步治疗,1例术后1年再次介入治疗,余患者疗效稳定。结论下肢动脉硬化闭塞症介入治疗方法多样,针对不同类型的病变采用相应的介入治疗手段,临床疗效安全、可靠。更多还原

【Abstract】 Objective To explore the technical methods and clinical efficacy of interventional treatments on atherosclerosis obliterans in lower-limb arteries.Methods Fifty-three patients with forty-eight stenosis changes and twenty-five occlusive changes received interventional treatments including percutaneous transluminal angioplasty(PTA),implantation of stent(IS),subintimal angioplasty(SIA) and mechanical thrombectomy(MTE).Results Ten changes with simple PTA and 20 with ally of IS(19 self-expandable stents and 5 recoiling stents),8 changes with simple MTE and 14 changes with ally of IS(19 self-expandable stents and 1 recoiling stents),5 changes with simple SIA and 11 changes with ally of IS(17 self-expandable stents and 2 recioling stents).In 66 successfully treated changes,there were 41 changes with relief of symptoms and signs,20 cases with obvious improvement,and 5 changes without any improvement.But 4 cases suffering operation to relieve the tension of lower extremities from ischemia-reperfusion injury and 2 cases suffering amputation.All the patients were followed-up for 2-33 months(mean 10.5 months).Among them,three cases with restenosis did not receive any interventional recanalisation after 6 months and two cases with restenosis after simple PTA successfully received IS.Conclusion Various interventional treatments have respective strong points to treat different atherosclerosis obliterans of arteries.Comprehensive application of them can be a safe and effective method for atherosclerosis obliterans of lower-limb arteries.更多还原