CAJ | 학술논문

目的：探讨锁骨下动脉慢性完全性闭塞( CTO)病程8 a的病变经皮腔内血管成形术( PTA)开通和成功植入支架的方法及效果.方法对头晕、头痛、左上肢无脉伴左上肢冷感、麻木、酸痛和活动时加重持续8a的患者经左锁骨下动脉造影证实为左锁骨下动脉CTO病变的病例行支架术治疗.经右股动脉入路,置入8F指引导管,应用冠状动脉介入导丝PROGRESS,在小球囊(1.5 mm×15 mm)的支撑下通过病变到达左锁骨下动脉远端.应用1.5 mm×20 mm、2.0 mm×20 mm和4.0 mm×15 mm Maverick冠脉球囊12~16 atm×30 s依次预扩张病变全程,植入6.0 mm×57 mm Express支架.结果支架植入后,病变血管恢复血流TIMIⅢ级,桡动脉波动有力,患肢血压恢复正常,患者症状消失.结论 PTA和支架术是持久开通锁骨下动脉闭塞的有效方法,且操作简便,安全,近期和远期效果好.
목적：탐토쇄골하동맥만성완전성폐새( CTO)병정8 a적병변경피강내혈관성형술( PTA)개통화성공식입지가적방법급효과.방법대두훈、두통、좌상지무맥반좌상지랭감、마목、산통화활동시가중지속8a적환자경좌쇄골하동맥조영증실위좌쇄골하동맥CTO병변적병례행지가술치료.경우고동맥입로,치입8F지인도관,응용관상동맥개입도사PROGRESS,재소구낭(1.5 mm×15 mm)적지탱하통과병변도체좌쇄골하동맥원단.응용1.5 mm×20 mm、2.0 mm×20 mm화4.0 mm×15 mm Maverick관맥구낭12~16 atm×30 s의차예확장병변전정,식입6.0 mm×57 mm Express지가.결과지가식입후,병변혈관회복혈류TIMIⅢ급,뇨동맥파동유력,환지혈압회복정상,환자증상소실.결론 PTA화지가술시지구개통쇄골하동맥폐새적유효방법,차조작간편,안전,근기화원기효과호.
Objective To explore the method and effects on successful recanalization of subclavian artery chronic total occlusions ( CTO ) lesions lasting for pathological course of eight years treated with percutaneous transluminal angioplasty( PTA) and stent implantation. Method The patients suffered from dizziness,headache and ischemic symptoms of left upper limb( cold feeling,numbness,pain,and activities increase) for eight years, and were proved to be CTO of the left subclavian artery by angiography and underwent stent implantation. The right femoral approach was used in the procedures. 8F guide catheter and PROGRESS guidewire ( coronary guidewire) were inserted into the ostium of left subclavian artery. With the support of the small balloon( diameter and length were 1. 5 mm×15 mm),the guidewire passed hard through the occluded lesions to distal vessel. Then the perdilatation for the entire lesions was performed with 1. 5 mm×20 mm,2. 0 mm×20 mm and 4. 0 mm×15 mm Maverick balloon with 12~16 atm for 30 seconds separately. Express stent(6. 0 mm×57 mm,Balloon expandable stent) was implanted with 16 atm × 30 seconds. Results After stenting, blood flow in the lesion blood vessel recovered to TIMI Ⅲ level, left radial artery fluctuations were clear, blood pressure of the left supper limb returned to normal,and the symptoms of ischemia disappeared. Conclusion PTA and stenting are effective and safe method for the persistent recanalization of subclavian artery CTO lesions, easy to operate, and have good immediate and long-term effects.