论文部分内容阅读
目的探讨逆向导丝技术治疗下肢动脉慢性闭塞(chronic total occlusion,CTO)病变介入治疗的技术要点、成功率及临床疗效。方法回顾性收集广东省人民医院2011年5月至2014年5月使用逆向导丝技术进行下肢动脉CTO病变经皮经腔血管成形术(percutaneous transluminal angioplasty,PTA)治疗的患者资料,分析逆向导丝各种方法特点、手术成功率,比较术前、术后Rutherford分级以及12个月保肢率。结果共筛查62例下肢动脉介入治疗患者,其中CTO病变45例,使用逆向导丝技术21例(经侧支循环路径13例,逆穿远端重建区血管8例),成功开通CTO病变16例,患者术后踝肱指数(ABI)平均值提高(P<0.05),Rutherford分级及跛行距离改善,1年的小范围肢体截肢率为9.52%,大范围肢体截肢率为10%。术中无主要并发症发生,无1例发生住院期间死亡。结论逆向导丝技术是下肢动脉CTO病变介入治疗的重要手术方式,能进一步提高手术成功率,有效改善下肢缺血程度。
Objective To investigate the technical points, success rates and clinical effects of reverse guide wire technique in interventional therapy of lower extremity chronic total occlusion (CTO). Methods We retrospectively collected data of patients treated with reverse guidewire technique in percutaneous transluminal angioplasty (PTA) of lower extremity arterial CTO lesions in Guangdong Provincial People’s Hospital from May 2011 to May 2014. The retrograde guide wire The characteristics of various methods, the success rate of surgery, preoperative and postoperative Rutherford classification and limb salvage rate of 12 months. Results A total of 62 patients with lower extremity arterial intervention were enrolled in this study. Of them, 45 patients had CTO lesion and 21 patients underwent reverse guided wire technique (13 cases of collateral circulation and 8 vessels transversally through distal reconstruction). CTO lesion 16 For example, the mean ankle-brachial index (ABI) was increased (P <0.05), the Rutherford grade and claudication distance were improved, and the rate of amputation was 9.52% in one year and 10% in a wide range of limbs. No major complications occurred during the operation, and no one died during hospitalization. CONCLUSION: Reverse guide wire technique is an important surgical approach for the interventional treatment of lower extremity arterial CTO lesions, which can further improve the success rate of operation and effectively improve the ischemia degree of lower extremities.