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目的探讨行外周血管支架置入术时经上肢动脉入路与经股动脉入路的适应证和优缺点。方法 97例患者(男62例,女35例)接受了外周血管支架置入术,其中同时放置2枚支架的患者15例。采用上肢动脉入路者有36例,采用股动脉入路者61名。结果 97名患者共放置112枚支架。双侧椎动脉安置支架33枚,其中经桡动脉入路22枚,占66.7%。双侧颈动脉、锁骨下动脉共安置支架47枚,其中经上肢动脉入路3枚,占6.4%。双侧肾动脉共安置支架32枚,其中经上肢动脉入路19枚,占59.4%。结论并不是所有外周血管狭窄病变都适合经上肢动脉行介入治疗,当主动脉弓严重迂曲或腹主动脉、髂动脉存在严重病变时时应及时选择上肢动脉途径。双侧椎动脉狭窄病变是经上肢动脉入路行介入治疗的最佳适应证,而锁骨下动脉及颈动脉狭窄病变仍要求首先考虑股动脉入路,肾动脉狭窄病变需要根据导管的长度、推送力等因素选择入路。
Objective To investigate the indications and advantages and disadvantages of trans-arterial approach and trans-femoral arterial approach in the setting of peripheral vascular stenting. Methods Ninety-seven patients (62 males and 35 females) received percutaneous transluminal coronary angioplasty (PCI), of which 15 were placed with two stents simultaneously. There were 36 cases of upper extremity arterial approach and 61 femoral artery approach. Results A total of 112 patients were placed in 97 patients. Bilateral vertebral artery stent placement 33, of which 22 through the radial artery approach, accounting for 66.7%. Bilateral carotid and subclavian artery were placed in 47 cases, of which 3 were involved by upper extremity artery, accounting for 6.4%. Bilateral renal artery placement bracket 32, of which 19 by the upper extremity artery approach, accounting for 59.4%. Conclusion Not all peripheral vascular stenosis is suitable for interventional treatment of the upper extremity arteries. When the aortic arch is severely tortuous or the abdominal aorta and iliac arteries are severely diseased, the upper extremity arterial route should be selected in time. Bilateral vertebral artery stenosis is the best indication for interventional treatment of the upper extremity arterial approach, and subclavian and carotid stenosis is still required to consider the femoral artery approach first, and the renal artery stenosis needs to be pushed according to the length of the catheter Force and other factors choose the way.