河北医科大学学报

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经皮腔内支架治疗锁骨下动脉闭塞的疗效评价

  

  1. (1. 河北省秦皇岛市第一医院心血管外科,河北 秦皇岛 066000 ; 2. 河北省秦皇岛市第一医院内分泌二科,河北 秦皇岛 066000 ;
    3. 首都医科大学宣武医院血管外科,北京 100053
  • 出版日期:2016-01-25 发布日期:2016-04-27
  • 作者简介:刘亚军( 1980- ),男,河北张家口人,河北省秦皇岛 市第一医院主治医师,医学博士研究生,从事心脏及血管外科疾病诊 治研究。
  • 基金资助:
    卫生部卫生行业科研专项项目( 201302008 )

Clinical effectiveness of endovascular therapy for total occlusion of the subclavian arteries

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  1. (
    1. DepartmentofCardiovascularSurgery , theFirstHospitalofQinhuangdaoCity , HebeiProvince ,
    Qinghuangdao 066000 , China ; 2. DepartmentofEndocrinology , theFirstHospitalofQinhuangdao
    City , HebeiProvince , Qinghuangdao 066000
    , China ; 3. DepartmentofVascularSurgery ,
    XuanWuHospitalofCapitalMedicalUniversity , Beijing 100053 , China
  • Online:2016-01-25 Published:2016-04-27

摘要: 目的 评估支架植入术治疗锁骨下动脉近端完全闭塞的临床效果。方法 锁骨下动脉完全闭塞患者
67 例均经皮腔内治疗,术后第 3 、 6 和 12 个月随访,此后每年随访 1 次。结果 15 例患者未能成功再通。 52 例患者
成功再通后行支架治疗,术后双上肢收缩压差明显低于术前;术后 12 个月通畅率为 98.
22% , 24 个月为 94. 31% , 3
年为 92.
17% ;围手术期无死亡患者,发生手术相关并发症 4 例; 37 例应用球扩式支架患者中有 5 例出现 >50% 的
症状性再狭窄。结论 如果技术熟练,掌握好适应证,介入腔内重建可作为治疗锁骨下动脉闭塞病变的优选方案,
若处理右侧闭塞病变则建议应用颈动脉保护伞预防远端栓塞。

关键词: 锁骨下动脉, 动脉闭塞性疾病, 支架

Abstract: ] Objective Thepurposeofthisstudywastoevaluatetheeffectivenessofstenting
therapyforthepatientswithtotalsubclavianarteryocclusion.Methods Atotalof67patients
hadunderwentendovasculartherapyforthetreatmentoftotalsubclavianarteryocclusion.All
patientswerefollowedat3 , 6 , and12monthsaftertreatmentandannuallythereafter.Results
52stentswereplaced.Technicalfailurewasnotedin15patients , whilethesymptomsfailedto
resolveintwo.Therewerenoperioperativedeaths.4complicationswereobserved.Therateof
primarypatencywas98.22% at12 months , 94.31% at24 months , and92.17% at3years.
Significantrecurrentobstructiondevelopedinfivepatientswhousedballoon-expandablestents.
Conclusion Whenperformedbyskilledsurgeons , endovasculartherapywithstentplacement
canbeusedasasafeandeffectivetherapyfortotalocclusionoftheproximalsubclavianartery.
However , embolicprotectiondevicesshouldbeconsideredduringthemanagementofrightside
occlusion.

Key words: subclavian artery, arterial occlusive diseases, stents