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主动脉-髂动脉闭塞介入重建术的中期随访

Mid-term follow-up of the percutaneous angioplasty of the occlusive aortoiliac artery diseases

摘要目的 评价主动脉-髂动脉闭塞介入治疗的中期疗效.方法 回顾性分析30例经介入治疗的腹主动脉.双侧髂动脉狭窄或闭塞患者的临床资料.30例中男24例、女6例,年龄35~75岁,平均(55±10)岁.采用导丝开通、导管溶栓、球囊扩张及支架置入等介入方法 治疗,出院后通过电话、信函、门诊复查等方式随访.结果26例腹主动脉-双侧髂动脉重建成功;3例分别因1条髂动脉开通失败仅腹主动脉.单侧髂动脉重建成功;1例主动脉-髂动脉重建失败.髂动脉破裂1例行WallGraft支架修补.术中发生远端动脉栓塞2例.1例一侧患肢缺血加重接受截肢.27例随访1~112个月,平均(41±9)个月.术后6个月髂动脉闭塞1例未能开通;25个月后双侧髂动脉闭塞1例,经球囊导管扩张治疗后3个月再闭塞,行双侧髂动脉支架置入.23例患肢均无症状再发或加重.结论主动脉-髂动脉介入重建术可有效恢复下肢血供,中期疗效良好.

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abstractsObjective To evaluate the mid-term follow-up of the pereutaneous angioplasty of the occlusive acrtoiliac artery diseases.Methods The data of 30 patients who had distal abdominal aorta and bi-lateral iliac artery stenosis or occlusion and treated by percutaneous angioplasty were retrospectively reviewed.They are 24 males and 6 females,aged from 35 to 75 years (average 55 ± 10 years). The interventional procedures include wire-guided canalization,thrembolysis,balloon angioplasty and stents implantation.They were followed up by telephone,letter or visiting after discharged.Results Twenty-six patients with aarto-iliac are revascularized successfully.Three cases failed.Of them,one failed because only one side of iliac artery and aorta were successfully canalized while the eontralateral not,one failed to revascularize both the aorta and the iliac artery,the other one failed due to the ihac rupture and replaced by WallGraft implantation.Two cases had distal thrombosis during the procedure.One case was amputated due to the aggravated isebemia of the right lower extremity after the revascularization failed.Twenty-seven cases were followed uo after 1 to 112 months,averaged (41±9) months.One case showed that the iliac artery was uncanalized after 6 months.One case showed bilateral iliac artery occlusion during 25 months follow-up and re-occluded 3 months after balloon angioplasty and finally had stent implanation in bilateral iliac artery.The other patients had no aggravated symptom of recurrence.Conclusion The percutaneous angioplasty is a good choice for occlusive aorto-iliac artery disease,showing good recovery during mid-term follow-up.

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中华放射学杂志

中华放射学杂志

2009年43卷4期

415-417页

ISTICPKUCSCDCA

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