TurboHawk斑块旋切系统在下肢动脉硬化闭塞症中的临床应用

Clinical application of TurboHawk plaque system in lower extremity atherosclerotic occlusive disease

摘要:

目的 评价TurboHawk斑块旋切系统在下肢动脉硬化闭塞症中的临床疗效和安全性。方法 回顾性分析2017年3月至2018年6月宜宾市第一医院血管外科收治的下肢动脉粥样硬化闭塞症患者23例的临床资料。选取TurboHawk斑块旋切系统进行介入手术治疗,所选患者均于术前和术后3d行踝肱指数(ABI)检查。术后随访6个月。对比患者手术前后的临床资料及随访结果。采用SPSS 19.0软件进行统计学分析。组间比较采用t检验。结果 与术前相比,患者术后3d的ABI显著增加[(0.81±0.13)和(0.26±0.19),t=31.52,P=0.012]。23例患者术后显效9例,有效14例。术后发生腹膜后血肿、斑块腓动脉栓塞、胫前动脉血管切破、股浅动脉夹层各1例,并发症发生率为17.4%(4/23),给予相应处理后均好转。术后随访6个月,所有患者均未出现明显静息痛,仅术后6个月增加了1例跛行患者。术前有6例下肢溃疡患者,均在术后4个月内愈合,随访过程无再发溃疡病例。患者术后6个月ABI与术后3d相比差异无统计学意义[(0.81±0.17)和(0.81±0.13),P>0.05]。结论 TurboHawk斑块旋切系统是下肢动脉硬化闭塞症患者介入开通的一种良好选择,疗效满意,安全性高,值得推广。

Abstract:

Objective To evaluate the clinical efficacy and safety of TurboHawk plaque system in lower extremity atherosclerotic occlusive disease. Methods A retrospective analysis was made of the clinical data of 23 patients with lower extremity atherosclerotic occlusive disease admitted to the Vascular Surgery Department of Yibin First People′s Hospital from March 2017 to June 2018. The TurboHawk plaque system was selected for intervention. An ankle brachial index (ABI) was performed for all the selected patients before and at 3 days after procedure. The patients were followed up for 6 months. The clinical data and follow-up findings before and after surgery were compared. SPSS statistics 19.0 was used for data analysis. The t test was used for comparison between groups. Results ABI at 3 days postoperatively was significantly higher than preoperative reading [(0.81±0.13) vs (0.26±0.19), t=31.52, P=0.012]. The treatment were markedly effective in 9 patients and effective in 14. Postoperative retroperitoneal hematoma occurred in 1 patient, plaque radial artery embolization in 1, anterior tibial artery rupture in 1, and superficial femoral artery dissection was performed in 1 patient, complication rate being 17.4%(4/23) and all being improved after treatment. After 6 months of follow-up, all patients showed no obvious resting pain, and only 1 patient developed claudication. All of the 6 patients with lower extremity ulcers were healed within 4 months after surgery without recurrent ulcers during follow-up. There was no significant difference in ABI at 6 months after surgery compared to 3 days after surgery [(0.81±0.17) vs (0.81±0.13), P>0.05]. Conclusion TurboHawk plaque system is an effective option worthy of popularization for patients with lower extremity atherosclerotic occlusive disease, with minimal invasiveness and satisfactory efficacy and safety.