股浅动脉支架术后闭塞的再次腔内治疗
The short-long term therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery
目的 观察股浅动脉支架术后闭塞经再次腔内治疗后的近远期效果,分析再次腔内治疗后再闭塞的危险因素.方法 回顾性分析2010年1月至2012年12月北京协和医院采用腔内技术治疗股浅动脉支架术后闭塞患者35例(38条肢体)的术后随访结果,分析其近远期疗效,并对再次腔内治疗后出现再闭塞的危险因素进行分析.结果 本组35例(38条肢体),男24例,女11例,平均年龄(68±8)岁.再次腔内手术成功率89.5%(34/38),其中14条肢体在支架内单纯球囊扩张,5条肢体支架内及支架远近端球囊扩张,15条肢体需要追加支架.术后6、12、24个月的一期通畅率分别为:65.2%、46.5%、46.5%;二期通畅率分别为:87.5%、80.2%、55.8%.多因素分析显示股浅动脉支架术后闭塞经腔内治疗后再次闭塞的独立危险因素包括:高龄(> 70岁)(P<0.05)、糖尿病(P<0.05).结论 再次腔内手术是目前治疗股浅动脉支架术后闭塞的安全有效的方式,近期疗效较好.高龄、糖尿病是导致股浅动脉再次腔内手术后再闭塞的独立危险因素.
更多Objective To evaluate therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery,and the risk factors of restenosis of re-intervention therapy.Methods We retrospectively summarized the clinical data of 35 patients(38limbs)who suffered from in-stent restenosis of superficial femoral artery(SFA)stent from 2010 to 2012.Results 35 patients (38 limbs)were enrolled in this study,there were 24 males and 11 females.Mean age was (68 ±8)years.The success rate of endovascular therapy was 89.5% (34/38),including in-stent angioplasty in 14 limbs,in-stent and beyond-stent angioplasty in 5 limbs,in-stent angioplasty and beyond-stent re-stenting in 15 cases.The primary patency and sencondary patency rate for 6,12 and 24 months was 65.2%,46.5%,46.5%,and 87.5%,80.2%,55.8% respectively.The independent risk factors for re-obliteration were age > 70 years (P < 0.05) and diabetes mellitus (P < 0.05).Conclusions Endovascular therapy is effective and safe in treatment in-stent restenosis of superficial femoral artery.The long-term in-stent patency is not satisfactory,with age > 70 years and diabetes mellitus as independent risk factors.
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