摘要
目的：探讨新一代人工血管支架Viabahn在股浅动脉支架再狭窄处理中应用的初期临床疗效。材料和方法：2013年4月收治的10例股浅动脉支架术后闭塞的患者，其中男6例，女4例，平均年龄68岁，所有病人均是近期患肢再发缺血症状，Fortaine Ⅱb级6例， Ⅲ级4例，术前患肢踝肱指数（ABI）：0~0.48。所有病人术前CT血管造影成像（CTA）均提示股浅支架内再狭窄，其中完全闭塞9例。所有病人均再次行腔内治疗，10例患者均成功开通狭窄、闭塞的病变，先予球囊扩张，再植入Viabahn支架（直径5、6、7 mm），复后再扩张，所有10例病人经过术后即刻造影评价血管通畅情况，术后当日测定ABI评价缺血改善情况，术后1周评价缺血等级改善，进而评价Viabahn的临床疗效。结果：所有10例病人成功的植入Viabahn支架15枚，技术成功率100%，无手术相关并发症出现。术后即刻造影结果：所有狭窄均消失，无残余狭窄存在。术后当日ABI测定0.76~0.96，较术前明显提高（t=-11.589，P=0.000）。术后1周Fortaine分级改善为：Ⅰ级7例，Ⅱa级3例。所有病例无任何操作相关的并发症出现。结论：Viabahn支架可以作为处理股浅动脉支架内再狭窄中一个安全、有效的选择。
Abstract
Objective: To report the initial experience of using Viabahn endoprothesis to treat the restenosis in superficial femoral artery. Materials and Methods: Ten cases of superficial femoral artery(SFA) in-stent restenosis were admitted due to lower limb ischemia in April 2013. All of the 10 patients were suffering from Fortaine Ⅱb or Ⅲ stage ischemia, with mean age of 68 years old. Preoperative CTA demonstrated obvious SFA in-stent restenosis, in which there were 9 total occlusion of the nitinol stents, the ABI: 0~0.48. We accomplished re-intervention with Viabahn(5~7 mm in diameter) for all 10 cases. Evaluation of treatment at immediate angiography, postoperative ABI, and 1 week after intervention for Fortaine ischemia classification. Results: Fifteen Vibahn endoprothesis were successfully implanted in all of the 10 cases. There are no residual stenosis in the immediate angiography with a significant improvement of ABI to 0.76~0.96(t=-11.589，P=0.000). The Fortaine ischemia classification were improved from Ⅱb toⅠand from Ⅲ to Ⅱa or Ⅰstage. Conclusion: The Viabahn endoprothesis might be a safe and effective approach for the treatment of SFA in-stent restenosis.
关键词
移植物闭塞 /
血管 /
动脉硬化 /
闭塞性 /
股动脉 /
支架
Key words
Graft occlusion /
vascular /
Arteriosclerosis obliterans /
Femoral artery /
Stents
纪东华;刘剑飞;张 涛;李 城;王 峰;刘永晟;李 枫;李 克.
Viabahn支架在处理股浅动脉支架内再狭窄中的初期应用经验[J]. 中国临床医学影像杂志. 2014, 25(1): 40-42
JI Dong-hua;LIU Jian-fei;ZHANG Tao;LI Cheng;WANG Feng;LIU Yong-sheng;LI Feng;LI Ke.
The initial experience of using the Viabahn for SFA in-stent restenosis[J]. Journal of China Clinic Medical Imaging. 2014, 25(1): 40-42
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