脉逆行内膜剥脱治疗下肢动脉粥样硬化闭塞症腔内治疗术.docxVIP

药物灌注球囊以及股动脉逆行内膜剥脱术治疗下肢动脉粥样硬化闭塞症腔内治疗术后再狭窄职康康刘炎东杨復唐柏俊邹思力吴永发吴鉴今季相国摘要目的：回顾性分析我单中心在下肢动脉粥样硬化症(arteriosclerosis obliterans,ASO)腔内治疗术后再狭窄的诊疗策略以及治疗特色。通过病例统计分析论述治疗策略的可行性以及安全性。方法：通过回顾性分析在2012年6月1日至2016年6月1日45例在我单中心行药物灌注球囊后行支架植入术以及15例股动脉逆行内膜剥脱术治疗下肢ASO支架植入术后再狭窄的病例，统计下肢ASO发生支架内再狭窄的肢体数目以及治疗后发生再狭窄肢体数，并且对这60例病人进行术后随访以判断上述治疗手段的有效性，可行性，安全性。结果：60例病人，共84条患肢，在行药物灌注球囊后支架植入术以及股动脉逆行内膜剥脱术后远端肢体得到充分血流灌注，患肢皮温较之前有明显改善，足背动脉可触及搏动，患者自觉患肢温暖，疼痛症状明显减轻，随访后药物球囊灌注组有2例发生治疗后再狭窄的情况，股动脉内膜剥脱组无再狭窄的情况。结论行药物灌注球囊后支架植入术以及股动脉逆行内膜剥脱术治疗下肢ASO支架植入术后再狭窄安全，有效，降低了治疗术后再狭窄后发生再狭窄的风险。关键词：动脉粥样硬化闭塞症，腔内治疗，术后再狭窄，股动脉逆行内膜剥脱术，药物灌注球囊AbstractObjective: Retrospective analysis of clinical technique and specialty?of treatments for vascular restenosis after stent implantation in?atherosclerosis lesions. This article aims to have a discussion about the effectiveness and safety of the two therapy strategies in our single unit.Methods: The clinical data of 45 cases who had received drug-perfused balloon and 15 cases who had received femoral artery retrograde endarterectomy after presenting reocclusion or restenosis atherosclerosis lesions from June 2012?to June 2016 in our Vascular Surgery were reviewed retrospectively. We collected the data?ofrestenosis or reocclusion cases following initial endovascular treatment and restenosis or reocclusion cases after our treatment in atherosclerosis in lower limb and evaluated the effectiveness, availability and safety of the two treatment strategies which are mentioned above by doing follow-up in these 60 patients.Results: 60 patients, altogether having 84 diseased limbs, had acquired an adequate blood perfusion in their distal limbs and got warmer on their feet after undergoing drug-perfused balloon and stent implantation or femoral artery retrograde endarterectomy. In addition, they can have good palpitation in dorsal artery of feet and have better feelings on account of relieving pain. In their follow-up, 2 restenosis cases have been found in the drug-perfused balloon group while no restenosisor re