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目的 探讨综合介入治疗老年周围动脉疾病的临床疗效及安全性。方法 采用经皮穿刺周围动脉血管球囊扩张术 (PTA)、支架置入、持续动脉内溶栓加PTA、血管内膜剥离术加支架置入术等综合介入方法治疗老年周围动脉阻塞性病变 6 2例次 ,其中上肢锁骨下动脉阻塞性病变 2 1例次 ,下肢动脉病变 4 1例次。单纯PTA 6例次 ,球囊预扩张加支架置入术 5 2例次 ,溶栓加PTA 3例次 ,股动脉内膜剥离术加髂动脉支架置入术 1例。结果 手术成功率95 % ,手术并发症 1.4 % (支架脱落 1例 )。术后即刻血管造影影像学和临床表现明显改善。随访 3个月～ 2年 ,无复发性肢体缺血症状生存 6 7% ,间歇性跛行较术前减轻并维持 13% ,临床再狭窄率 2 0 %。结论 老年周围动脉阻塞性病变综合介入治疗近、远期疗效满意 ,手术安全可靠 ,肢体复发性缺血症状发生率相对较低 ,是目前治疗老年周围动脉疾病的有效方法之一
Objective To investigate the clinical efficacy and safety of comprehensive interventional treatment of peripheral arterial disease in the elderly. Methods Percutaneous puncture of peripheral arterial balloon angioplasty (PTA), stent implantation, continuous intra-arterial thrombolysis combined with PTA, endovascular dissection and stent implantation were used to treat obstructive pulmonary artery occlusion 2 cases, including 21 cases of obstructive lesions of the subclavian artery in upper limbs and 41 cases of arterial lesions in the lower extremities. PTA alone 6 cases, balloon dilatation and stent placement of 52 cases, thrombolysis plus PTA 3 cases, femoral artery intimal delamination plus iliac artery stent implantation in 1 case. Results The success rate of surgery was 95% and the complications of surgery were 1.4% (1 case of stent ablation). Immediate postoperative angiography and clinical manifestations improved significantly. The follow-up ranged from 3 months to 2 years. The survival of non-recurrent limb ischemia was 67%. The intermittent claudication was reduced and maintained at 13% and the rate of clinical restenosis was 20%. Conclusions Comprehensive interventional treatment of obstructive peripheral arterial occlusive disease in the elderly has satisfactory efficacy in long-term and long-term, safe and reliable operation and relatively low incidence of recurrent ischemic limbs, which is one of the effective methods for the treatment of peripheral arterial disease in the elderly