A single-center, retrospective study of the surgical treatment of aortoiliac occlusive disease
吕俊兵 1招扬 1贺海朋 1林任 1彭嘉欣 1钱结胜 1殷恒讳 1王丽萍
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作者信息
1. 中山大学附属第三医院血管外科，广州 510000
折叠
摘要
目的 探讨主髂动脉闭塞症（AIOD）外科治疗方式的选择。 方法 回顾性分析2020年4月至2022年10月中山大学附属第三医院血管外科收治并行外科治疗的21例AIOD患者的临床资料。其中Rutherford 3期3例，4期8例，5~6期10例。采取开放手术（腹主动脉-双髂/股动脉人工血管旁路移植术）、腔内手术（腹主动脉-双髂动脉球囊扩张+对吻支架植入术）及杂交手术（双侧股动脉切开取栓+支架植入术）治疗并随访观察患者临床改善及血管通畅情况。 结果 21例患者中，13例患者行开放手术，4例行腔内手术，4例行杂交手术，闭塞血管均完全开通，手术成功率100.0%。1例开放手术患者术后出现肾功能不全，短期透析后肾功能恢复正常。1例腔内治疗患者于术后12 d因急性心功能衰竭死亡。20例患者获得随访，中位随访时间为23.0（15.5，27.8）个月。随访期内，1例开放手术患者出现人工血管内血栓形成，行支架植入后重新开通，余患者未出现明显并发症。 结论 综合考虑AIOD患者的病变累及范围、病变性质、一般情况等多方面因素并加以个体化选择手术方式，均可取得安全、有效的临床效果。 Objective To investigate the choice of surgical treatment for the aortoiliac occlusive disease(AIOD). Methods The clinical data of 21 patients (19 male and 2 female) with AIOD who received surgical treatment in the Department of Vascular Surgery of the Third Affiliated Hospital of Sun Yat-sen University from April 2020 to October 2022 were analyzed retrospectively. According to the Rutherford classification, there were 3 cases of grade 3, 8 cases of grade 4, and 10 cases of grade 5-6. Open surgery (abdominal aorta-bilateral iliac/femoral artery bypass grafting), endovascular surgery (abdominal aorta-bilateral iliac artery balloon dilation and kissing-stent implantation), and hybrid surgery (bilateral femoral artery thrombectomy and stent implantation) were performed. The clinical improvement and vascular patency of patients were followed up and observed. Results Among the 21 patients, 13 patients underwent open surgery, 4 underwent endovascular surgery and 4 underwent hybrid surgery. The operation success rate was 100.0% and all occlusive vessels were completely opened. Renal insufficiency occurred in 1 patient after open surgery and recovered after short-term dialysis. A total of 20 patients were followed up for 23.0 (15.5, 27.8) months. During the follow-up, in the open surgery group, thrombosis in the artificial vessels developed in 1 case and recanalized after stent implantation. No significant complications in the remaining patients. Conclusion A safe and effective clinical result can be achieved by comprehensively considering the lesion involvement, lesion characteristics, and general condition of patients with AIOD, and offering individualized treatment.
Abstract
Objective To investigate the choice of surgical treatment for the aortoiliac occlusive disease(AIOD). Methods The clinical data of 21 patients (19 male and 2 female) with AIOD who received surgical treatment in the Department of Vascular Surgery of the Third Affiliated Hospital of Sun Yat-sen University from April 2020 to October 2022 were analyzed retrospectively. According to the Rutherford classification, there were 3 cases of grade 3, 8 cases of grade 4, and 10 cases of grade 5-6. Open surgery (abdominal aorta-bilateral iliac/femoral artery bypass grafting), endovascular surgery (abdominal aorta-bilateral iliac artery balloon dilation and kissing-stent implantation), and hybrid surgery (bilateral femoral artery thrombectomy and stent implantation) were performed. The clinical improvement and vascular patency of patients were followed up and observed. Results Among the 21 patients, 13 patients underwent open surgery, 4 underwent endovascular surgery and 4 underwent hybrid surgery. The operation success rate was 100.0% and all occlusive vessels were completely opened. Renal insufficiency occurred in 1 patient after open surgery and recovered after short-term dialysis. A total of 20 patients were followed up for 23.0 (15.5, 27.8) months. During the follow-up, in the open surgery group, thrombosis in the artificial vessels developed in 1 case and recanalized after stent implantation. No significant complications in the remaining patients. Conclusion A safe and effective clinical result can be achieved by comprehensively considering the lesion involvement, lesion characteristics, and general condition of patients with AIOD, and offering individualized treatment.
关键词
主髂动脉闭塞症/开放手术/腔内手术/杂交手术
Key words
Aortoiliac occlusive disease/Open surgery/Endovascular surgery/Hybrid surgery
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