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股浅动脉闭塞性病变中Outback LTD导管的应用分析

Recanalization of superficial femoral artery occlusions with Outback LTD catheter

摘要:

目的 探讨股浅动脉慢性完全闭塞性病变(CTO)中应用Outback LTD导管内膜下成形术治疗技术的近中期结果.方法 2010年1月至2011年5月,30例股浅动脉CTO的35条肢体应用Outback LTD导管进行治疗.其中男性20例,女性10例,平均年龄68岁.重度间歇性跛行10条肢体(Rutherford 3级,28.6%),静息痛13条肢体(Rutherford 4级,37.1%),小面积溃疡12条肢体(Rutherford 5级,34.3%).所有患者术中应用常规的导管和导丝技术无法顺行从内膜下返回真腔.统计技术成功率、相关并发症及操作时间.随访中计算支架通畅率和治疗结果.结果 平均病变长度为(210±15)mm,操作技术成功率为97.1% (34/35),无操作相关的并发症发生.平均随访时间(7.2±0.3)个月.随访3、6、12个月支架一期通畅率分别为90.9%、84.8%和50.6%.重度缺血病变中,3条肢体行截趾术,1条行膝关节以下的截肢术.结论 Outback LTD导管在股浅动脉CTO内膜下成形术中能够安全、有效地辅助导丝返回真腔,缩短射线暴露时间,提高技术成功率.

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abstracts:

Objective To evaluate immediate- and median-term outcomes from subintimal recanalization of superficial femoral arteries (SFA) chronic total occlusions (CTO) with the Outback LTD catheter.Methods From January 2010 to May 2011,35 legs in 30 patients with CTO of the SFA and proximal popliteal artery were treated by Outback LTD catheter.There were 20 male and 10 female patients.The mean age of the patients was 68 years. Clinical presentation was severe intermittent claudication (Rutherford category 3,10/35,28.6% ),rest pain (Rutherford category 4,13/35,37.1% ),and minor ulceration (Rutherford category 5,12/35,34.3% ).In all cases,the true lumen could not be entered by using standard antegrade catheter and guide wire techniques.Technical success,complications,procedure times,clinical outcomes and cumulative patency rates in follow-up were evaluated.Results Median lesion length was (210 ± 15) mm.Recanalization of the arterial occlusion was successful in 34 of 35 treated lesions (97.1% ).None of the 30 patients showed any procedure-related complications during or after treatment.The mean follow-up was (7.2 ± 0.3 ) months.Cumulative primary patency rates after 3,6,and 12 months were 90.9%,84.8% and 50.6%.Three minor toe amputations and one major below-the-knee amputation were observed in patients with critical limb ischemia.Conclusions The Outback LTD catheter is a safe and effective device to recanalize challenging superficial femoral arteries CTO. The technique could reduce radiation exposure time and raise the technique success rate.

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作者: 张宏鹏 [1] 郭伟 [1] 刘小平 [1] 尹太 [1] 贾鑫 [1] 王立军 [1] 熊江 [1] 马晓辉 [1]
第一作者: 张宏鹏
期刊: 《中华外科杂志》2012年50卷3期 226-229页 MEDLINEISTICPKUCSCD
分类号: R322.121
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2012.03.010
发布时间: 2012-04-20
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