CAJ | 학술논문

目的：探讨TASC（Ⅱ）D型股动脉闭塞的腔内治疗方法及效果。方法回顾性分析2012年1月-2013年5月采用腔内治疗TASC(Ⅱ)D型股浅动脉闭塞26例（26肢）患者的临床资料。其中采用球囊扩张内支架置入13例（裸支架组，共植入支架31枚）、Silverhawk斑块旋切6例（Silverhawk斑块旋切组）、Viabahn覆膜支架2例（Viabahn覆膜支架组）。腔内手术未成功通过病变者5例给予前列地尔等扩血管药物治疗。通过手术前后踝肱指数(ABI)、螺旋CT血管成像（CTA）、数字减影血管造影（DSA）及症状改善情况来评价疗效；并于术后6个月复查CTA。结果26例中成功开通目标动脉21例（技术成功率80.7%），造影证实血流通畅，残留狭窄小于30%，术后患肢缺血症状缓解。术后1周ABI高于术前（0.77±0.10 vs 0.43±0.15，t=7.948，P＜0.05）。6个月一期通畅比例分别为裸支架组9/13，Silver-hawk斑块旋切组4/6，Viabahn覆膜支架2/2。结论腔内治疗TASC（Ⅱ）D型股动脉闭塞可提高近期通畅率，Viabahn覆膜支架是治疗的新手段。
목적：탐토TASC（Ⅱ）D형고동맥폐새적강내치료방법급효과。방법회고성분석2012년1월-2013년5월채용강내치료TASC(Ⅱ)D형고천동맥폐새26례（26지）환자적림상자료。기중채용구낭확장내지가치입13례（라지가조，공식입지가31매）、Silverhawk반괴선절6례（Silverhawk반괴선절조）、Viabahn복막지가2례（Viabahn복막지가조）。강내수술미성공통과병변자5례급여전렬지이등확혈관약물치료。통과수술전후과굉지수(ABI)、라선CT혈관성상（CTA）、수자감영혈관조영（DSA）급증상개선정황래평개료효；병우술후6개월복사CTA。결과26례중성공개통목표동맥21례（기술성공솔80.7%），조영증실혈류통창，잔류협착소우30%，술후환지결혈증상완해。술후1주ABI고우술전（0.77±0.10 vs 0.43±0.15，t=7.948，P＜0.05）。6개월일기통창비례분별위라지가조9/13，Silver-hawk반괴선절조4/6，Viabahn복막지가2/2。결론강내치료TASC（Ⅱ）D형고동맥폐새가제고근기통창솔，Viabahn복막지가시치료적신수단。
Objective To investigate methods and results of endovascular treatment in TASC (Ⅱ) D-type femoral artery occlusion. Methods From January 2012 to May 2013, 26 cases (26 branches) of superficial femoral artery occlusion with endovascular treatment of TASC (Ⅱ) D-type superficial femoral artery occlusion were retrospectively reviewed. The effi-cacy was evaluated through ABI, CTA, DSA and symptoms improved. Results 26 branches were treated with endovascular methods. Technical success rate was 80.7%(21/26), including 13 branche with stent implantation, 6 branches with Silver-hawk atherectomy and 2 branches with Viabahn stent implantation. All patients were followed up for a mean period of (10.3 ± 1.2)months, primary patency rates at 6 months were 69.2%in stent group, 66.7%in Silverhawk atherectomy group and 100%in Viabahn stent group. Conclusion Endovascular treatment of TASC (Ⅱ) D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment.