摘要目的 探讨同侧股浅动脉逆行入路经皮腔内血管成形术(PTA)治疗下肢动脉慢性完全闭塞性病变(CTO)的临床应用和临床效果.方法 回顾性分析2013年1月至2015年1月急诊外科59例股浅动脉近端及中段病变患者,均运用PTA和支架植入术治疗,其中17例采用同侧股浅动脉逆行入路治疗股浅动脉近端及中段闭塞,病变长度6.5~13.4(8.3±2.9)cm,右侧11条,左侧8条.术后1、3、6、9、12、18、24个月随访.结果 19条股浅动脉均治疗成功,使闭塞症段动脉得到再通,未出现相邻血管、神经损伤等严重并发症,24个月内随访通畅率为14/19,踝肱指数:治疗前为0.20~0.51(0.39±0.06),治疗后0.65~1.15(0.74±0.13),两者比较差异有统计学意义(P<0.05).结论 经同侧股浅动脉逆行入路治疗股浅动脉近端及中段闭塞病变是一种有效安全的方法.

abstractsObjective To investigate the clinical application and value of retrograde catheterization via superficial femoral artery for the treatment of limb chronic total occlusive disease (CTO). Methods Fifty-nine patients with proximal and middle occlusive lesions of superficial femoral artery from Jan. 2013 to Jan. 2015 in department of emergency surgery were retrospectively analyzed. Percutaneous transluminal angioplasty (PTA) together with stent implantation was performed to reopen the all narrowed or obstructed superficial femoral artery.Seventeen patients received ipsilateral retrograde catheterization via superficial femoral artery together. The length of the diseased artery ranged from 6.5 to 13.4 cm, with a mean of (8.3 ± 2.9) cm, including right (11 cases)and left (8 cases) femoral arteries. After the interventional therapy patients were followed up for 1- 24 months. Results All patients were treated successfully. The proximal and middle occlusive lesions of superficial femoral artery were reopened.No serious complications were found including nerve and vessel damage+After the treatment, the ischemic symptoms were markedly improved or even disappeared. In 14/19 of patients the superficial femoral arteries remained patent during the follow-up period. The ankle preoperative brachial index (ABI) was 0.20 to 0.51 (0.39 ± 0.06), while the postoperative ABI was 0.65 to 1.15 (0.74 ± 0.13). The difference in ABI between pre-operation and post-operation was statistically significant (P<0.05). Conclusions Retrograde catheterization via superficial femoral artery is an effective alternative to treat proximal and middle occlusion of ipsilateral superficial femoral artery. It has high successful rate and safety.