锁骨下动脉完全闭塞的腔内治疗:单中心回顾性研究
Endovascular treatment of total subclavian artery occlusion:A single-center retrospective study
杨心志 1牛国晨 1李鹏宇 1姚子平 1张碧辉 1闫子光 1杨敏1
作者信息
- 1. 北京大学第一医院 介入血管外科,北京 100034
- 折叠
摘要
目的 探讨腔内治疗锁骨下动脉完全闭塞的有效性和远期通畅率.方法 回顾性收集2018 年 6 月至 2023 年 6 月北京大学第一医院 38 例行腔内治疗的锁骨下动脉完全闭塞患者临床资料,分析患者的手术成功率、并发症、症状缓解率和随访通畅率.结果 技术成功率为 92.1%(35/38),其中顺行及逆行再通的成功率分别为 78.9%(30/38)和 62.5%(5/8).病变近端残端形态分型平钝型开通成功率比鸟嘴型更低(66.6%比 94.1%,P=0.039).症状缓解率为 93.5%(29/31),无围手术期并发症发生.患者术后随访 6～68 个月,中位随访时间 38 个月,6 例患者出现再狭窄,Kaplan-Meier分析显示术后 5 年通畅率为 77.4%,未发现锁骨下动脉闭塞患者远期通畅率的独立预后因素.结论 腔内治疗锁骨下动脉完全闭塞安全有效,远期通畅率较高.
Abstract
Objective To explore the clinical efficacy and long-term patency rate of endovascular treatment of total subclavian artery occlusion.Methods The clinical data of 38 patients with total subclavian artery occlusion undergoing endovascular treatment at Peking University First Hospital from June 2018 to June 2023 were collected retrospectively.The technical success rate,complications,symptom remission rate and follow-up patency rate of the patients were analyzed.Results The technical success rate was 92.1%(35/38),and the success rates of antegrade and retrograde recanalization were 78.9%(30/38)and 62.5%(5/8)respectively.According to the morphology of the proximal stump of the lesion,the obtuse type has a lower opening success rate than that of the beak type(66.6%vs 94.1%,P=0.039).The symptom relief rate was 93.5%(29/31),and no perioperative complications occurred.Patients were followed up for 6 to 68 months after surgery,with a median follow-up time of 38 months.Six patients developed restenosis.Kaplan-Meier analysis showed that the 5-year postoperative patency rate was 77.4%.No independent prognostic factor of long-term patency was found in patients with subclavian artery occlusion.Conclusion Endovascular treatment for total subclavian artery occlusion is safe and effective,which offers satisfactory long-term patency rate.
关键词
动脉闭塞性疾病/锁骨下动脉/腔内治疗/支架Key words
Arterial occlusive diseases/Subclavian artery/Endovascular treatment/Stents引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据