摘要
目的 评价平行支架技术治疗主髂动脉闭塞性疾病(aortoiliac occlusive disease,AIOD)的中远期效果.方法 回顾性分析2017年3月至2019年5月在西南医科大学附属医院接受平行支架(金属裸支架或覆膜支架)植入重建主髂动脉的18例有症状AIOD患者临床资料.其中男14例,女4例,年龄(64.8±9.0)岁.记录手术细节、临床成功、并发症和通畅率.结果 所有患者均获手术技术和临床成功.共植入62枚支架(金属裸支架52枚,覆膜支架9枚,肾动脉球囊扩张支架1枚).术后出现腔隙性脑梗死、肱动脉假性动脉瘤、血红蛋白降低、血栓移入肾动脉各1例,经积极处理后出院,并发症发生率为4/18.随访期间3例患者出现再狭窄,再次血管腔内干预后恢复了通畅.术后12、18、24、30、36个月主要通畅率分别为100％、95％、90％、85％、85％.结论 平行支架技术治疗AIOD 3年效果令人满意,即使是复杂AIOD患者也有较高的技术成功率和可接受的中远期通畅率.
Abstract
Objective To evaluate the medium-to-long-term efficacy of parallel stenting technology in treating aortoiliac occlusive disease(AIOD).Methods The clinical data of 18 patients with symptomatic AIOD,who received parallel stenting(using metal bare stent or covered stent)to reconstruct the aortoiliac artery at the Affiliated Hospital of Southwest Medical University of China from March 2017 to May 2019,were retrospectively analyzed.The patients included 14 males and 4 females with a mean age of(64.78±9.04)years.The surgical details,clinical success,complications,and stent patency rate were recorded.Results Both technical success and clinical success were achieved in all patients.A total of 62 stents were implanted,including 52 bare metal stents,9 covered stents and one renal artery balloon dilatation stent.After stent implantation,one patient each developed lacunar cerebral infarction,brachial artery pseudoaneurysm,decreased hemoglobin level,and thrombus migration into the renal artery,and after active management the patients were well discharged.The incidence of complications was 22％(4/18).During the follow-up period,3 patients developed in-stent restenosis,and the vascular lumen returned to patency after a second time of endovascular intervention.The postoperative 12-,18-,24-,30-,and 36-month main patency rates were 100％,95％,90％,85％,and 85％,respectively.Conclusion For the treatment of AIOD,parallel stenting technology has obtained satisfactory 3-year results.For the patients with complicated AIOD,this technique also carries a high technical success rate and an acceptable medium-to-long-term patency rate.
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