Leriche综合征血管腔内治疗效果分析

发布时间：2018-02-05 02:17

本文关键词： Leriche综合征经皮腔内血管成形术主髂动脉　出处：《介入放射学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的评价血管腔内治疗Leriche综合征的效果。方法收集2010年9月至2014年10月收治的57例Leriche综合征患者临床资料,对经皮腔内血管成形术(PTA)治疗结果进行分析。结果 57例患者(65条患肢)中接受单纯PTA术2例,导管接触溶栓(CDT)后PTA结合支架植入5例,PTA结合支架植入50例,共植入支架97枚,技术成功率100%。踝-肱指数(ABI)由术前平均0.42±0.22改善至术后平均0.83±0.15,差异有显著统计学意义(P0.01)。平均随访(9.8±2.8)个月,6、12个月一期通畅率分别为95.4%、90.7%,二期通畅率为96.4%。所有患者术后下肢缺血症状均得到改善。围手术期发生髂动脉球囊扩张破裂2例,肱动脉穿刺点假性动脉瘤1例,穿刺点血肿3例,脑梗死2例,心肌梗死1例。对比剂肾病1例,最终并发多脏器功能障碍综合征死亡,围手术期死亡率1.75%。1例二期处理后3个月出现支架内再闭塞,予人工血管旁路移植术。结论 PTA术治疗Leriche综合征安全可靠,并发症少,围手术期死亡率低,近期通畅率可。
[Abstract]:Objective to evaluate the efficacy of endovascular treatment for Leriche syndrome. Methods 57 cases of Leriche syndrome were collected from September 2010 to October 2014. The results of percutaneous transluminal angioplasty (PTA) were analyzed. After catheter contact thrombolytic thrombolytic therapy (CDT), PTA and stent implantation were performed in 5 cases (50 cases), and 97 stents were implanted. The malleolus brachial index (ABI) was improved from 0.42 卤0.22 before operation to 0.83 卤0.15 after operation. The difference was statistically significant (P 0.01). The average follow-up time was 9.8 卤2.8 months. The one-stage patency rate in 12 months was 95.7%. The secondary patency rate was 96.4.The symptoms of lower extremity ischemia were improved in all patients. During perioperative period, iliac artery balloon dilation and rupture occurred in 2 cases, brachial artery puncture point pseudoaneurysm in 1 case, puncture point hematoma in 3 cases. 2 cases of cerebral infarction, 1 case of myocardial infarction, 1 case of contrast nephropathy, finally complicated with multiple organ dysfunction syndrome died, perioperative mortality of 1.75.1 cases of secondary treatment 3 months after the stent re-occlusion. Conclusion PTA is safe and reliable in the treatment of Leriche syndrome with less complications and lower perioperative mortality.
【作者单位】：西南医科大学附属医院血管外科;
【分类号】：R654.3
【正文快照】： Leriche综合征又称主髂动脉闭塞性疾病(AIOD),指腹主动脉末端或双侧髂动脉闭塞引起双下肢动脉搏动减弱、间歇性跛行及阳痿三联征[1]。患者年龄均60岁且伴有多种基础疾病,传统开放手术创伤大,并发症多。血管腔内介入治疗在现阶段已取得巨大突破,具有操作简单、创伤小及并发症

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