摘要
目的评估机械血栓清除装置联合药物涂层球囊(DCB)导管治疗股腘动脉支架内再狭窄(FP-ISR)的安全性及中远期疗效。方法收集2016年6月至2017年7月首都医科大学附属北京朝阳医院收治的32例接受机械血栓清除装置联合DCB导管治疗的FP-ISR患者的临床资料,对患者的5年随访数据进行分析。分析患者的术后3、5年原发通畅率和免于临床驱动的靶病变血运重建(CD-TLR)率、手术治疗情况、不同Rutherford分级患者的治疗情况、不良事件发生率、截肢情况、死亡情况及步行障碍调查问卷(WIQ)评分。结果32例FP-ISR患者的技术成功率和治疗成功率均为100%(32/32),其中,26例患者完成了5年随访。术后5年的WIQ评分为(49.28±24.62)分,踝肱指数(ABI)为(0.77±0.12),分别高于术前的(30.45±21.14)分、(0.45±0.14),差异均有统计学意义(P﹤0.05)。术后3年,原发通畅率为81.5%(22/27),免于CD-TLR率为85.2%(23/27)。术后5年,原发通畅率为76.9%(20/26),免于CD-TLR为80.8%(21/26)。结论机械血栓清除装置联合DCB导管治疗FP-ISR具有良好的中远期效果,安全性较高。
Objective To evaluate the safety and mid-term and long-term efficacy of the mechanical thrombectomy device combined with drug-coated balloon(DCB)catheter in the treatment of femoropopliteal artery in-stent restenosis(FP-ISR).Method The clinical data of FP-ISR patients treated with the mechanical thrombectomy device combined with DCB catheter in Beijing Chao-yang Hospital,Capital Medical University from June 2016 to July 2017 were collected,the 5-year follow-up data of the patients were analyzed.The 3-year,5-year postoperative primary patency rate and target lesion free from clinically-driven target lesion revascularization(CD-TLR),surgical treatment,treatment of patients with different Rutherford grades,the incidence of adverse events,amputation,mortality,and walking impairment questionnaire(WIQ)scores were analyzed.Result The technical and treatment success rates of 32 FP-ISR patients were 100%(32/32),and 26 patients completed the 5-year follow-up.The ankle brachial index(ABI)at five years after the operation was(0.77±0.12),which was higher than that before the operation(0.45±0.14),and the difference was statistically significant(P<0.05).The WIQ score at five years after the operation was(49.28±24.62),which was higher than that before the operation(30.45±21.14),respectively,and the difference was statistically significant(P<0.05).Three years after the operation,the primary patency rate was 81.5%(22/27),and the rate of freedom from CD-TLR was 85.2%(23/27).Five years after the operation,the primary patency rate was 76.9%(20/26),and the rate of freedom from CD-TLR was 80.8%(21/26).Conclusion Mechanical thrombectomy device combined with DCB catheter in the treatment of FP-ISR has good mid-term and long-term effects with high safety.
作者
张杨
廖传军
李谈
宋盛晗
张望德
Zhang Yang;Liao Chuanjun;Li Tan;Song Shenghan;Zhang Wangde(Department of Vascular Surgery,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China)
出处
《血管与腔内血管外科杂志》
2023年第5期520-524,539,共6页
Journal of Vascular and Endovascular Surgery
基金
北京中和公益基金(ZHKT22-01)。
关键词
股腘动脉病变
支架内再狭窄
机械血栓清除装置
药物涂层球囊导管
安全性
疗效
femoropopliteal artery disease
in-stent restenosis
mechanical thrombectomy device
drug-coated balloon catheter
safety
efficacy
