中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
11期
883-886
,共4页
动脉硬化,闭塞性%血管成形术%腘动脉
動脈硬化,閉塞性%血管成形術%腘動脈
동맥경화,폐새성%혈관성형술%객동맥
Arteriosclerosis obliterans%Angioplasty%Popliteal artery
目的 研究腘动脉局域超选法在完成股浅动脉顺向内膜下开通中的作用.方法 2009年1月至2011年12月对467例患者(550条肢体)行腔内治疗,病变均为泛大西洋协作组(Trans-Atlantic Inter-Society Consensus,TASC)定义的ⅡC/D级股腘动脉闭塞.统计其中直接应用腘动脉局域超选技术和传统真腔超选方法的62条肢体,观察其手术成功率、手术时间、症状改善和随访情况.结果 在550条肢体中,62条肢体直接应用了腘动脉局域超选技术,其中9条肢体未能顺向返回真腔操作.53条肢体(85.5％)完成手术,平均手术时间(69 ±24) min,平均支架应用数(1.8±0.6)枚,平均覆盖长度(33 ±6) cm.46条肢体(86.8％)术后早期症状有所改善,6条无明显变化,1条截肢.39条肢体术后随访1年,6个月通畅率为87.1％,12个月通畅率69.2％.另外488条肢体应用传统超选方法的肢体中,完成顺向开通378条(77.5％),平均手术时间(89±30)min,平均支架应用数(2.1±0.6)枚,平均覆盖长度(31 ±13) cm.79.4％( 300/378)的肢体术后早期症状得到改善,292条肢体进行了术后1年的随访,6个月通畅率为92.1(269/292),12个月通畅率61.0％(178/292).结论 股浅动脉长段闭塞患者的腔内治疗中,采用腘动脉局部超选法可以在不增加移植物基础上有效缩短手术时间.
目的 研究腘動脈跼域超選法在完成股淺動脈順嚮內膜下開通中的作用.方法 2009年1月至2011年12月對467例患者(550條肢體)行腔內治療,病變均為汎大西洋協作組(Trans-Atlantic Inter-Society Consensus,TASC)定義的ⅡC/D級股腘動脈閉塞.統計其中直接應用腘動脈跼域超選技術和傳統真腔超選方法的62條肢體,觀察其手術成功率、手術時間、癥狀改善和隨訪情況.結果 在550條肢體中,62條肢體直接應用瞭腘動脈跼域超選技術,其中9條肢體未能順嚮返迴真腔操作.53條肢體(85.5％)完成手術,平均手術時間(69 ±24) min,平均支架應用數(1.8±0.6)枚,平均覆蓋長度(33 ±6) cm.46條肢體(86.8％)術後早期癥狀有所改善,6條無明顯變化,1條截肢.39條肢體術後隨訪1年,6箇月通暢率為87.1％,12箇月通暢率69.2％.另外488條肢體應用傳統超選方法的肢體中,完成順嚮開通378條(77.5％),平均手術時間(89±30)min,平均支架應用數(2.1±0.6)枚,平均覆蓋長度(31 ±13) cm.79.4％( 300/378)的肢體術後早期癥狀得到改善,292條肢體進行瞭術後1年的隨訪,6箇月通暢率為92.1(269/292),12箇月通暢率61.0％(178/292).結論 股淺動脈長段閉塞患者的腔內治療中,採用腘動脈跼部超選法可以在不增加移植物基礎上有效縮短手術時間.
목적 연구객동맥국역초선법재완성고천동맥순향내막하개통중적작용.방법 2009년1월지2011년12월대467례환자(550조지체)행강내치료,병변균위범대서양협작조(Trans-Atlantic Inter-Society Consensus,TASC)정의적ⅡC/D급고객동맥폐새.통계기중직접응용객동맥국역초선기술화전통진강초선방법적62조지체,관찰기수술성공솔、수술시간、증상개선화수방정황.결과 재550조지체중,62조지체직접응용료객동맥국역초선기술,기중9조지체미능순향반회진강조작.53조지체(85.5％)완성수술,평균수술시간(69 ±24) min,평균지가응용수(1.8±0.6)매,평균복개장도(33 ±6) cm.46조지체(86.8％)술후조기증상유소개선,6조무명현변화,1조절지.39조지체술후수방1년,6개월통창솔위87.1％,12개월통창솔69.2％.령외488조지체응용전통초선방법적지체중,완성순향개통378조(77.5％),평균수술시간(89±30)min,평균지가응용수(2.1±0.6)매,평균복개장도(31 ±13) cm.79.4％( 300/378)적지체술후조기증상득도개선,292조지체진행료술후1년적수방,6개월통창솔위92.1(269/292),12개월통창솔61.0％(178/292).결론 고천동맥장단폐새환자적강내치료중,채용객동맥국부초선법가이재불증가이식물기출상유효축단수술시간.
Objective To evaluate popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization.Methods From January 2009 to Dec 2011,550 limbs in 476 TASC (Trans-Atlantic Inter-Society Consensus) Ⅱ C/D cases underwent endo-therapy at our department.The success rate、operation time、symptom progress and follow up were analyzed retrospectively.Results In the 550 limbs,62 limbs received popliteal artery local technique directly.There was 9 technical failures.Procedures succeeded in 53 limbs(85.5％ ).The average operation time was (69 ±24) min,(1.8 ±0.6) stents were used and the main covered length was ( 33 ± 6) cm.Symptoms of 46 limbs was improved and unchanged in 6,amputation needed to be done in one limb.One year follow up accomplished for 39 limb.The 6 and 12 months patence rate was 87.1％ and 69.2％.For 488 limbs using traditional approach 378 achieved anti-grade recanalization,the average operation time was ( 89 ± 30) min,average (2.1 ± 0.6) stents were used and the main covered length is (31 ± 13) cm.Symptom in 300 limbs improved.The half and one year patence rate in 292 limbs was 92.1％ and 61.0％.Conclusions The popliteal artery local technique is as effective as with traditional approach and is time saving.
