中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2008年
9期
974-977
,共4页
姜在波%钱结胜%李征然%黄明声%陈燕铭%李名安%王革%李晓晖%许长谋%朱康顺%关守海%单鸿
薑在波%錢結勝%李徵然%黃明聲%陳燕銘%李名安%王革%李曉暉%許長謀%硃康順%關守海%單鴻
강재파%전결성%리정연%황명성%진연명%리명안%왕혁%리효휘%허장모%주강순%관수해%단홍
桡动脉%髂动脉%股动脉%动脉硬化,闭塞性%放射学,介入性
橈動脈%髂動脈%股動脈%動脈硬化,閉塞性%放射學,介入性
뇨동맥%가동맥%고동맥%동맥경화,폐새성%방사학,개입성
Radial artery%Iliaco artery%Femoral artery%Arteriosclerosis obliteram%Radiology,interventional
目的 回顾性分析经桡动脉途径介入治疗髂动脉股动脉硬化闭塞症的安全性及其临床疗效.方法 经桡动脉途径介入治疗16例复杂髂动脉股动脉硬化性闭塞症患者,病程3 d至2年.所有患者均合并静息痛,间歇性跛行距离小于500 m,单侧病变9例、双侧病变7例,术前踝肱指数0～0.57(0.32±0.14).髂动脉股动脉完全闭塞6例,其余10例狭窄程度＞75%.留置导管于血栓内或其上方持续滴注尿激酶,如果溶栓72 h没有效果,停止溶栓.血栓溶解后,对残余狭窄程度＞50%的患者给予球囊、支架成形术.比较手术前、后患者的症状及踝肱指数变化,结果采用配对t检验.结果 16例患者溶栓时间3.0～15.0(8.4±2.9)d,15例血管再通.16例患者静息疼痛症状消失;4例仍有间歇性跛行,距离均大于500 m,与术前相比踱行距离明显延长;术后踝肱指数为0.63～1.10(0.91±0.12),较术前明显升高(t=21.73,P＜0.01).随访时间6～24个月,随访期间症状复发1例,再次介入治疗成功.所有患者未发生手术相关严重并发症.结论 经桡动脉途径长时间连续溶栓联合球囊扩张以及支架成形术治疗髂动脉股动脉硬化闭塞症,安全性高、患者耐受性好,是经股动脉途径介入治疗的补充,尤其对于复杂的双侧髂动脉股动脉病变的介入治疗具有更大的优势.
目的 迴顧性分析經橈動脈途徑介入治療髂動脈股動脈硬化閉塞癥的安全性及其臨床療效.方法 經橈動脈途徑介入治療16例複雜髂動脈股動脈硬化性閉塞癥患者,病程3 d至2年.所有患者均閤併靜息痛,間歇性跛行距離小于500 m,單側病變9例、雙側病變7例,術前踝肱指數0～0.57(0.32±0.14).髂動脈股動脈完全閉塞6例,其餘10例狹窄程度＞75%.留置導管于血栓內或其上方持續滴註尿激酶,如果溶栓72 h沒有效果,停止溶栓.血栓溶解後,對殘餘狹窄程度＞50%的患者給予毬囊、支架成形術.比較手術前、後患者的癥狀及踝肱指數變化,結果採用配對t檢驗.結果 16例患者溶栓時間3.0～15.0(8.4±2.9)d,15例血管再通.16例患者靜息疼痛癥狀消失;4例仍有間歇性跛行,距離均大于500 m,與術前相比踱行距離明顯延長;術後踝肱指數為0.63～1.10(0.91±0.12),較術前明顯升高(t=21.73,P＜0.01).隨訪時間6～24箇月,隨訪期間癥狀複髮1例,再次介入治療成功.所有患者未髮生手術相關嚴重併髮癥.結論 經橈動脈途徑長時間連續溶栓聯閤毬囊擴張以及支架成形術治療髂動脈股動脈硬化閉塞癥,安全性高、患者耐受性好,是經股動脈途徑介入治療的補充,尤其對于複雜的雙側髂動脈股動脈病變的介入治療具有更大的優勢.
목적 회고성분석경뇨동맥도경개입치료가동맥고동맥경화폐새증적안전성급기림상료효.방법 경뇨동맥도경개입치료16례복잡가동맥고동맥경화성폐새증환자,병정3 d지2년.소유환자균합병정식통,간헐성파행거리소우500 m,단측병변9례、쌍측병변7례,술전과굉지수0～0.57(0.32±0.14).가동맥고동맥완전폐새6례,기여10례협착정도＞75%.류치도관우혈전내혹기상방지속적주뇨격매,여과용전72 h몰유효과,정지용전.혈전용해후,대잔여협착정도＞50%적환자급여구낭、지가성형술.비교수술전、후환자적증상급과굉지수변화,결과채용배대t검험.결과 16례환자용전시간3.0～15.0(8.4±2.9)d,15례혈관재통.16례환자정식동통증상소실;4례잉유간헐성파행,거리균대우500 m,여술전상비탁행거리명현연장;술후과굉지수위0.63～1.10(0.91±0.12),교술전명현승고(t=21.73,P＜0.01).수방시간6～24개월,수방기간증상복발1례,재차개입치료성공.소유환자미발생수술상관엄중병발증.결론 경뇨동맥도경장시간련속용전연합구낭확장이급지가성형술치료가동맥고동맥경화폐새증,안전성고、환자내수성호,시경고동맥도경개입치료적보충,우기대우복잡적쌍측가동맥고동맥병변적개입치료구유경대적우세.
Objective To study the safety and effect of interventional treatment for arteriesclerotic obliterations of iliaco-fermoral artery via radial artery retrospectively.Methods Sixteen cages were treated with interventional procedare via radial artery.The duration of disease was from 3 days to 2 years.All cases presented with rest pain and intermittent claudicating(with distance less than 500 m).Unilateral lesions were found in 9 cases.and bilateral lesions in 7 cases.Iliaco-femoral arteries were obliterated completely in 6 cases.while the other ten cases had arterial stenesis more than 75%.After visualization of obliterative artery.urokinase was administrated consecutively from catheter indweUed in or above thrombus.Transcatheter thrombolysis would be cancelled if the therapeutic effect wag negligible after using umkinase for 72 hours.After thrombolysis.the balloon angioplasty and the stent implantation were performed in the cases with residual stenesis more than 50%. In all of 16 cases,5 caseg underwent continuous intraarterial thrombolysis only.11 cases received balloon angioplasty and/or stent implantation additionally.The ankle/braehial index(ABI)post-treatment and pre-treatment was analyzed.Results The duration of transcatheter thrombolysis was 3.0-15.0 days,averaged(8.4±2.9)days.The obliterative arteries were recanalized in 15 cases.The symptoms of rest pain disappeared in all cases.while intermittent claudicating was still present in 4 cases,but the claudicating distance increased significantly(92.50±60.21 and 625.00±84.26 m for pre-and post-operation respectively).The ABl was 0.63-1.10(0.91±0.12)for post-treatment and 0-4).57(0.32±0.14)for pre-treatment respectively(t=21.73,P＜0.01).During 6-24 months' follow-up,restenosis occurred in 1 case,which was treated successfully once again after halloon angioplasty.There was no serious complication related to the procedure.Conclusion It is safe and effective to apply continuous thrombolysis combined with balloon angioplasty and stent implantation to treat iliacofemoral artery obliteration interventionally via radial arterv.
