摘要
目的探讨SilverHawk斑块切除术的安全性和有效性。方法 2010年10月～2011年4月对14例动脉粥样硬化导致的下肢缺血施行SilverHawk斑块切除,支架后再闭塞或狭窄内膜切除9例,单纯下肢动脉斑块切除5例。采用同侧顺行股动脉穿刺6例,对侧股动脉逆行穿刺6例,左侧腋动脉穿刺1例,左侧腋动脉和左股动脉逆行穿刺1例。结果 14例手术均成功,出院时所有患者的再通血管保持通畅。7例间歇性跛行行走距离均增加到500 m以上,静息痛5例全部缓解,1例足趾溃疡面积由术前的3 cm×4 cm缩小为2 cm×2 cm,坏疽1例保持干燥出院。术后ABI 4例0.7～0.8,4例0.81～0.9,6例0.91以上。14例随访1～5个月,平均3.5月,1例间歇性跛行4个月后症状复发,1例坏疽因足部骨髓炎而膝下截肢,1例溃疡面愈合,静息痛无复发。结论 SilverHawk斑块切除技术是一种安全有效的方法,但疗效尚需要远期的随访结果验证。
Objective To explore the safety and efficacy of endovascular plaque excision with SilverHawk.MethodsClinical data of 14 patients with atherosclerotic lower extremity ischemia,who received SilverHawk plaque excision,were retrospectively analyzed.In the patients,excision of the hyperplastic arterial intema was done in 9 patients with poststenting arterial restenosis or occlusion;simple plaque excision in the lower extremity was made in the other 5.Ipsilateral antegrade femoral artery puncture was carried out in 6 patients;contralateral retrograde femoral artery puncture was done in 6 patients;puncture in the left axilliary artery was made in 1 patient;retrograde femoral artery puncture was made in 1 patient.Results All the operations were completed successfully,and all the patients were discharged with patent recanalized artery.Claudication distance increased to more than 500 meters in the 7 patients who had the symptom,and rest pain was relieved in all the 5 patients who suffered from it.In one patient,who had toe ulcer,the size of the ulcer decreased from 3 cm×4 cm to 2 cm×2 cm;and in the other one,who had necrosis,the lesion was dry at discharge from hospital.Postoperative ABI was 0.7-0.8 in 4 patients,0.81-0.9 in 4,and 0.91 in 6.The patients were followed up for 1-5 months（mean,3.5 months）,during which one of them had recurrent intermittent claudication in four months;the case of necrosis received amputation because of foot osteomyelitis;one patient had the ulcer healed;no recurrent rest pain was complained.Conclusions Plaque excision with SilverHawk is safe and effective.Further follow-up is necessary to confirm its long-term efficacy.
出处
《中国微创外科杂志》
CSCD
2011年第11期1022-1024,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
动脉粥样硬化
斑块切除
下肢缺血
Arteriosclerosis
Plaque excision
Lower limb ischemia
