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准分子激光治疗股腘动脉支架内再狭窄的临床研究

Clinical study of excimer laser atherectomy for femoropopliteal in-stent restenosis
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摘要 目的探讨准分子激光联合药物涂层球囊(DCB)治疗股腘动脉支架内再狭窄(ISR)的可行性及安全性。方法回顾性分析股腘动脉ISR患者的临床资料,其中36例准分子激光斑块消蚀术(ELA)+普通球囊血管成形术(POBA)+DCB治疗者为观察组;57例POBA+DCB治疗者为对照组。观察两组手术成功率、并发症发生率、术后即刻最小管腔直径(MLD)、术后3天踝肱指数(ABI)等。术后随访:1、3、6、12月彩超和ABI,12月靶病变血流重建(TLR)、ISR、截肢率、MLD、晚期管腔丢失(LLL)等指标。结果术前两组患者性别、年龄、TASCⅡ分级以及合并症等基线资料比较,差异无统计学意义。术后1、3、6、12月ABI,12月TLR、ISR、截肢率、MLD、LLL等指标,观察组优于对照组(P均<0.05)。结论 ELA+POBA+DCB治疗股腘动脉ISR安全有效,近中期效果优于POBA+DCB。 Aim To discuss the safety and curative efficiency of excimer laser ablation (ELA) combined with drug-coated balloon(DCB) angioplasty treating in-stent restenosis(IRS) of femoral-popliteal artery. Methods This study retrospectively analyzed all 36 clinical data of patients whose femoral-popliteal artery has IRS and treated by excimer laser ablation (ELA) combined with plain old balloon angioplasty(POBA) and DCB angioplasty between March 2017 to Feburary 2018. 36 patients were treated as the observation group, and 57 patients whose treatment is POBA combined with DCB angioplasty were treated as control group. Observe the success rate of surgery, complication rate, minimum lumen diameter (MLD) immediately after surgery, ankle brachial index(ABI) in the third day after surgery etc. Postoperatively follow up ABI in the first, third, sixth, twelfth month after surgery, target lesion revascularization(TLR) rate in twelve months, ISR, amputation rate, MLD, late lumen loss(LLL) etc. Results There was no significant difference between the two groups in terms of gender, age, TASCII grade, and other comorbidities (P>0.05). It analyzed the ABI at 1,3, 6 and 12 months after operation, and the TLR, ISR, amputation rate, MLD and LLL at 12 months after operation.The P values were all less than 0.05, and the observation group was superior to the control group. Conclusion ELA combined with POBA and DCB is safe and effective in the treatment of femoral-popliteal artery ISR, with short and moderate-term effect better than POBA combined with DCB.
作者 杨森 何菊 李胜玉 李晓锋 刘辉 赵健 刘明明 YANG Sen;HE Ju;LI Shengyu;LI Xiaofeng;LIU Hui;ZHAO Jian;LIU Mingming(Department of Vascular Surgery, Tianjin First Central Hospital, Tianjin 300192, China)
出处 《中国动脉硬化杂志》 CAS 2019年第4期349-353,共5页 Chinese Journal of Arteriosclerosis
基金 天津市科技计划项目(18ZXDBSY00110) 天津市卫生局科技基金(2014KZ024).
关键词 动脉硬化闭塞症 支架植入术 再狭窄 准分子激光 球囊 arteriosclerosis obliterans stent implantation restenosis excimer laser balloon
作者简介 杨森,硕士,主治医师,研究方向为周围血管外科疾病的手术和微创治疗,E-mail为410017220@qq.com;通信作者:何菊,主任医师,研究方向为周围血管外科疾病的手术和微创治疗,E-mail为hejutian@163.com.
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