泛大西洋协作组织ⅡD型主髂动脉闭塞性疾病腔内治疗的疗效分析

Efficacy of endovascular treatment for Trans-Atlantic Inter-Society ConsensusⅡD aortoiliac occlusive disease

摘要:

目的 探讨腔内治疗复杂泛大西洋协作组织(TASC)ⅡD型主髂动脉闭塞性疾病(AIOD)的疗效及预后。方法 回顾性分析2014年12月至2018年12月期间山西医科大学第一医院收治的69例TASCⅡD型AIOD患者的临床资料,共79条患肢。术前根据Fontaine分期及相应的影像学检查拟定治疗方案。要求患者出院后3、6、12个月及每年门诊复查,分析其临床症状、踝肱指数(ABI)、并发症和通畅率。采用SPSS 17.0软件进行数据处理。组间比较采用t检验。结果 腔内治疗总体成功率为94.2%(65/69),术后共有4例(5.8%)患者发生并发症。65例患者均随访6个月以上,4例患者12个月后失访,20例患者24个月后失访。术后3个月的ABI显著高于术前[(0.81±0.15)和(0.38±0.12),P<0.05]。术后1年通畅率96.7%(59/61),2年通畅率88.9%(40/45)。结论 腔内治疗TASCⅡD型AIOD是一种安全、有效的治疗措施,并可获得满意的临床效果及近中期通畅率。

Abstract:

Objective To investigate the clinical efficacy of endovascular treatment of the complex Trans-Atlantic Inter-Society Consensus (TASC)ⅡD aortoiliac occlusive disease (AIOD). Methods A retrospective analysis was made of the clinical data of 69 patients treated by vascular surgery for TASCⅡD aortic and iliac artery disease in the First Hospital of Shanxi Medical University. Before the operation, a therapeutic protocol was instituted according to Fontaine staging and corresponding imaging examination. All the patients were treated endoscopically and were followed up regularly for 3 to 36 months on phone or at the outpatient clinic. Analyses were made of their clinical symptoms, ankle brachial index (ABI), complications, and patency rate. SPSS statistics 17.0 was used for data analysis, and t test was used for comparison between groups. Results The overall success rate of endovascular therapy was 94.2% (65/69), and postoperative complications occurred in 4(5.8%). Sixty-five patients were followed up for more than 6 months, 4 were lost after 12 months, and 20 were lost after 24 months. ABI at 3 months after operation was significantly higher than that before admission [(0.38±0.12) vs (0.81±0.15), P<0.05]. Patency rate was 96.7%(59/61) after one year and 88.9%(40/45) after two years. Conclusion Endovascular therapy is safe and effective for TASCⅡD AIOD with satisfactory clinical outcomes and short- to mid-term patency rates.