摘要
目的探讨药物洗脱支架(DES)对下肢动脉硬化性闭塞症(PAD)合并慢性肾功能不全(CKD)患者的疗效。方法收集2022年7月至2023年7月于中国中医科学院西苑医院行DES治疗的53例PAD-CKD患者的临床资料,观察术后3、6、12个月靶病变通畅情况、再次血运重建情况以及有无不良事件,分析不同外周动脉钙化评分系统(PACSS分级)患者靶血管通畅率。结果所有患者均顺利完成手术,无手术相关的不良事件。术后3、6、12个月,靶病变一期通畅率分别为90.57%(48/53)、86.79%(46/53)、81.13%(43/53),不同PACSS分级患者随访期间靶血管通畅率比较,差异均有统计学意义(P﹤0.05)。术后3、6、12个月,免于靶病变血运重建率分别为96.23%(51/53)、88.68%(47/53)、84.91%(45/53),不同PACSS分级患者随访期间免于靶病变血运重建率比较,差异均有统计学意义(P﹤0.05)。术后溃疡愈合率为82.50%(33/40),平均溃疡愈合时间(4.22±0.18)个月。不同PACSS分级患者靶血管再狭窄率比较,差异有统计学意义(P﹤0.05)。结论DES治疗下肢PAD合并CKD患者安全、有效,且通畅性随着PACSS分级的增高而降低。
Objective To investigate the efficacy of drug-eluting stents(DES)in patients with peripheral arterial disease(PAD)complicated with chronic kidney dysfunction(CKD).Method Clinical data of 53 patients with PAD-CKD who received DES treatment in Xiyuan Hospital,China Academy of Chinese Medical Sciences from July 2022 to July 2023 were collected.The patency of target lesions,revascularization and adverse events 3,6 and 12 months after surgery were observed,the patency rate of target vessels in patients with different peripheral arterial calcium scoring system(PACSS)grades was analyzed.Result All patients successfully completed surgery without surgery-related adverse events.At 3,6 and 12 months after surgery,the primary patency rates of target lesions were 90.57%(48/53),86.79%(46/53)and 81.13%(43/53),respectively,there were statistically significant differences in the patency rates of target vessels in patients with different PACSS grades during follow-up(P<0.05).At 3,6 and 12 months after surgery,the rates of revasectomy free from target lesions were 96.23%(51/53),88.68%(47/53)and 84.91%(45/53),respectively,there were statistically significant differences in the rates of revasectomy free from target lesions in patients with different PACSS grades during follow-up(P<0.05).The ulcer healing rate was 82.50%(33/40),and the average ulcer healing time was(4.22±0.18)months.The comparison of target vessel restenosis rates among patients with different PACSS grades showed statistically significant differences(P<0.05).Conclusion DES treatment is safe and effective for patients with lower extremity PAD combined with CKD,and its patency decreases with increasing PACSS grading.
作者
王煜杰
李志娟
李旭东
石波
杨淼
Wang Yujie;Li Zhijuan;Li Xudong;Shi Bo;Yang Miao(Department of Peripheral Vascular Diseases,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)
出处
《血管与腔内血管外科杂志》
2024年第10期1161-1165,1206,共6页
Journal of Vascular and Endovascular Surgery
基金
中国中医科学院科技创新工程(C12021A01909)。
关键词
下肢动脉硬化性闭塞症
慢性肾功能不全
药物洗脱支架
血管钙化
lower extremity arteriosclerosis occlusion dysfunction
chronic kidney disease
drug-eluting stent
vascular calcification
