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长段股浅动脉硬化性闭塞症腔内治疗后支架内再狭窄原因研究

Study on the causes of restenosis after endovascular treatment of long segment superficial femoral artery occlusion

摘要:

目的 探讨长段股浅动脉硬化性闭塞症腔内治疗后支架内再狭窄的原因.方法 回顾性分析38例长段股浅动脉硬化性闭塞症患者的临床资料,均采用球囊扩张+支架植入术治疗.于术后6和12个月随访间歇性跛行距离变化,并行彩色多普勒血管超声检查,根据是否发生支架内再闭塞或狭窄将患者分为通畅组及再狭窄组,比较两组患者的临床资料.结果 随访结果显示,通畅24例(通畅组),再狭窄或闭塞14例(再狭窄组).再狭窄组踝肱指数(ABI)明显低于通畅组(0.47±0.41比0.50±0.48),差异有统计学意义(P<0.05).根据实际情况将数据进行分级,结果显示,病变长度>30cm、支架长度>30cm、年龄>70岁是长段股浅动脉硬化性闭塞症患者腔内治疗后支架内再狭窄的危险因素(P<0.05).结论 腔内治疗长段股浅动脉硬化性闭塞症安全有效,ABI降低、病变长度>30cm、支架长度>30cm、年龄>70岁是腔内治疗后支架内再狭窄的危险因素.

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Objective To study the causes of restenosis after endovascular treatment of long segment superficial femoral artery occlusion.Methods The clinical data of 38 patients with long segment superficial femoral artery occlusion were retrospectively analyzed,and the patients were treated with balloon dilatation and stent implantation.The patients were followed up 6 and 12 months after operation.The changes of claudication distance were observed,and the patients underwent color Doppler vascular ultrasound examination.The patients were divided into patency group and restenosis group according to the results of follow up, and the clinical data were compared between 2 groups.Results The follow-up result showed that patency was in 24 cases(patency group),and restenosis or occlusion was in 14 cases(restenosis group).The ankle brachial index(ABI)in restenosis group was significantly lower than that in patency group: 0.47 ± 0.41 vs.0.50 ± 0.48, and there was statistical difference (P<0.05).The data were classified according to the actual situation.Results showed that the lengths of occlusion segment >30cm, lengths of stent >30cm and age>70 years were the risk factors of restenosis after endovascular treatment in patients with long segment superficial femoral artery occlusion (P<0.05).Conclusions The endovascular treatment of long segment superficial femoral artery occlusion is safe and effective.The lower ABI,lengths of occlusion segment>30cm,lengths of stent>30cm and age>70 years are the risk factors of restenosis after endovascular treatment in patients with long segment superficial femoral artery occlusion.

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