Iliac Artery Percutaneous Transluminal Angioplasty(PTA) as an Adjuvant for Surgical Treatment of Advanced Infrainguinal Arterial Occlusive Disease

本研究用以評估對於包括骼動脈及鼠蹊部以下動脈之多部位下肢動脈阻塞疾病病患，施以骼動脈血管成形術，以輔助外科治療合併之鼠蹊部以下病灶之效果。21位患有多部位下肢動脈阻塞疾病的患者，接受骼動脈血管成形術以輔助外科治療。患者年齡分佈從49歲至80歲（平均73.2歲）。血管攝影發現骼動脈狹窄有15人，阻塞有6人。所有病患均合併有嚴重的股或摑動脈或更末端動脈的狹窄或阻塞。11位患者接受雙側而另外10位患者接受單側之骼動脈成形術，其中有3三位病患因為術後動脈剝離而須置放動脈內金屬支架。21位病患中，18位成功地增加了下肢血流而避免了剖腹之骼動脈繞道手術，僅有3位病患仍須接受繞道手術，臨床上成功率為86%。病患後續接受的外科治療有：股動脈至末端動脈繞道手術13位（繞道手術後，仍須施行之治療有植皮2位，腳趾截除4位，及膝關節以下截肢1位），植皮l位及膝關節以下截肢4位。患肢存留率為72%(13/18)，四年之臨床通暢率為70%。骼動脈血管成形術可有效增加周邊血流以輔助手術治療合併之鼠蹊部以下動脈阻塞疾病。

關鍵字

骼動脈；動脈阻塞；血管成形術；血管重建

並列摘要

This study was performed to assess percutaneous transluminal angioplasty (PTA) as a surgical adjuvant for the patients who suffer from multiple areas of arterial obstruction including iliac and infrainguinal arteries. We performed PTA of iliac artery in twenty-one patients who suffered from multiple areas of arterial occlusive disease in their lower extremities as a surgical adjuvant. The age range was 49 to 80 years old (mean-73.2 years old). Stenosis of iliac artery was identified in 15 patients and occlusion in 6 patients. All of the patients had concomitant advanced arterial stenosis or occlusion of femoropopliteal artery and/or distal trifurcation. PTA for bilateral iliac arteries was performed for 11 patients and unilateral for 10. Endovascular metallic stents was placed in iliac arteries on account of severe arterial dissection after PTA in 3 patients. Eighteen patients had increased inflow to their lower legs and avertted the necessity of intraabodominal bypass surgery. However, 3 patients still needed aortofemoral bypass due to acute occlusion after PTA in one case and persisted inadequate flow in the other two. The clinical successful rate was 86% (18/21). The following surgical treatments were: Femoro-to-distal arterial bypass in 13. (concomitant treatments following bypass surgery were skin graft in 2, disarticulation of toe in 4 & one patient still needed limited below knee amputation to remove the infected foot), skin grafting in 1, and limited below-knee amputation in 4 patients. The limb salvage rate was 72% (13/18). The 4 year clinical patency rate was 70%. PTA of iliac artery is useful to increase peripheral blood blow as an adjuvant for surgical treatment of infrainguinal arterial occlusive disease.

並列關鍵字

Arteries, iliac ； arteries, stenosis or obstruction ； transluminal angioplasty ； vascular reconstruction

國際替代計量

Iliac Artery Percutaneous Transluminal Angioplasty(PTA) as an Adjuvant for Surgical Treatment of Advanced Infrainguinal Arterial Occlusive Disease

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