外周血管病变支架的应用(摘要)
作者：荆全民 韩雅玲 苗志林 佟铭
单位：辽宁省沈阳市，中国人民解放军沈阳军区总医院 心内科(110015)
关键词：
目的 目的：外周血管病变临床常见，我科自1995年10月至1999年6月先后对16例外周血管病变患者进行了经皮腔内血管成形术(PTA)及支架治疗，观察外周血管病变支架应用效果。
方法：16例中男12例，女4例，平均46岁。病因考虑为大动脉炎的7例，动脉粥样硬化的9例。应用JR4造影导管造影明确诊断，PTA术前常规服用阿司匹林300 mg/d,术前静脉注射肝素1万单位。应用0.035英寸直导丝通过狭窄或闭塞血管段后，再送入直径6～8 mm,长度为30～60 mm外周球囊导管至狭窄处，以4～8 atm反复扩张。预扩张后，置放Wall支架或NIR(9 cell)支架，释放支架后，再送球囊以8～10 atm扩张整形。术后服用华法林3 mg/d或噻氯匹定250 mg 2次/日，共1个月。
, http://www.100md.com
结果：血管造影示16例中4例为左锁骨下动脉70%～90%狭窄；6例肾动脉病变者中，1例为左侧肾动脉完全闭塞，2例为双侧肾动脉80%～90%狭窄，4例髂总动脉病变，其中2例为双侧闭塞病变，1例为右侧完全闭塞病变；另2例股动脉系完全闭塞病变。16例中成功开通血管15例，成功率93.7%,置放支架17枚，全部获得成功。术后1周出院。有8例于术后3个月至1年进行了造影随访，血管支架再狭窄2例，再狭窄率12.5%。
结论：血管内支架应用可以增加即刻PTA的成功率，明显降低术后再狭窄率，临床应用近期及远期效果均满意。
Stents Used in the Peripheral Arterial Disease (Abstract)
Department of Cardiology, General Hospital of Shenyang Military Command, Shenyang (110015), Liaoning
, 百拇医药
Jing Quanmin, Han Yaling, Miao Zhilin, et al.
Objective： The occlusion lesion of peripheral artery was often found in clinic. From October 1995 to June 1999, we performed percutaneous transluminal angioplasty (PTA) and implanted stents in 16 cases with occlusion lesion of peripheral artery to observe the efficacy of stents in the occlusion lesion of peripheral artery.
Methods: 16 cases (12 males and 4 females, mean age of 46 years) with aorto-arteritis in 7 and atherosclerosis in 9 underwent. Peripheral angiograph by JR 4 catheter to determine the stenosis degree of arterial lesion. Before PTA, Aspirin 300 mg was taken and heparin 10 000 U was injected from the catheter. When 0.035 inch straight wire passed the occlusion or stenosis of artery, the balloon catheter (diameter 6～8 mm with length 30～60 mm) was pushed to the target lesion, and expanded the balloon with 4～6 atm. After the procedure, the Wall stent or NIR stent was placed. Wafarin 3 mg or Ticlid 500 mg was taken daily for one month.
, 百拇医药
Results: The vascular angiograph showed that lesions located in left subclavian artery in 4 cases with stenosis 70%～90%; In 6 cases of renal artery lesion, one was left renal artery occlusion, two were bilateral renal stenosis; In 4 cases of common iliac artery lesion, two were bilateral occlusion, and one was right occlusion; Another 2 cases were total occlusion of femoral artery. We successfully revascularized 15 target lesions (success rate 93.7%), and 17 stents were successfully implanted. Patients were discharged about one week after PTA. Eight cases were followed up by peripheral angiograph 3～12 months after PTA. The vascular restenosis was found in 2 cases. Restenosis rate was 12.5%.
Conclusion: Endovascular stents can increase the instant success rate and decrease the restenosis rate of PTA. From our preliminary experience, stents used in peripheral arterial disease had both a good instant and long term effect., 百拇医药
单位：辽宁省沈阳市，中国人民解放军沈阳军区总医院 心内科(110015)
关键词：
目的 目的：外周血管病变临床常见，我科自1995年10月至1999年6月先后对16例外周血管病变患者进行了经皮腔内血管成形术(PTA)及支架治疗，观察外周血管病变支架应用效果。
方法：16例中男12例，女4例，平均46岁。病因考虑为大动脉炎的7例，动脉粥样硬化的9例。应用JR4造影导管造影明确诊断，PTA术前常规服用阿司匹林300 mg/d,术前静脉注射肝素1万单位。应用0.035英寸直导丝通过狭窄或闭塞血管段后，再送入直径6～8 mm,长度为30～60 mm外周球囊导管至狭窄处，以4～8 atm反复扩张。预扩张后，置放Wall支架或NIR(9 cell)支架，释放支架后，再送球囊以8～10 atm扩张整形。术后服用华法林3 mg/d或噻氯匹定250 mg 2次/日，共1个月。
, http://www.100md.com
结果：血管造影示16例中4例为左锁骨下动脉70%～90%狭窄；6例肾动脉病变者中，1例为左侧肾动脉完全闭塞，2例为双侧肾动脉80%～90%狭窄，4例髂总动脉病变，其中2例为双侧闭塞病变，1例为右侧完全闭塞病变；另2例股动脉系完全闭塞病变。16例中成功开通血管15例，成功率93.7%,置放支架17枚，全部获得成功。术后1周出院。有8例于术后3个月至1年进行了造影随访，血管支架再狭窄2例，再狭窄率12.5%。
结论：血管内支架应用可以增加即刻PTA的成功率，明显降低术后再狭窄率，临床应用近期及远期效果均满意。
Stents Used in the Peripheral Arterial Disease (Abstract)
Department of Cardiology, General Hospital of Shenyang Military Command, Shenyang (110015), Liaoning
, 百拇医药
Jing Quanmin, Han Yaling, Miao Zhilin, et al.
Objective： The occlusion lesion of peripheral artery was often found in clinic. From October 1995 to June 1999, we performed percutaneous transluminal angioplasty (PTA) and implanted stents in 16 cases with occlusion lesion of peripheral artery to observe the efficacy of stents in the occlusion lesion of peripheral artery.
Methods: 16 cases (12 males and 4 females, mean age of 46 years) with aorto-arteritis in 7 and atherosclerosis in 9 underwent. Peripheral angiograph by JR 4 catheter to determine the stenosis degree of arterial lesion. Before PTA, Aspirin 300 mg was taken and heparin 10 000 U was injected from the catheter. When 0.035 inch straight wire passed the occlusion or stenosis of artery, the balloon catheter (diameter 6～8 mm with length 30～60 mm) was pushed to the target lesion, and expanded the balloon with 4～6 atm. After the procedure, the Wall stent or NIR stent was placed. Wafarin 3 mg or Ticlid 500 mg was taken daily for one month.
, 百拇医药
Results: The vascular angiograph showed that lesions located in left subclavian artery in 4 cases with stenosis 70%～90%; In 6 cases of renal artery lesion, one was left renal artery occlusion, two were bilateral renal stenosis; In 4 cases of common iliac artery lesion, two were bilateral occlusion, and one was right occlusion; Another 2 cases were total occlusion of femoral artery. We successfully revascularized 15 target lesions (success rate 93.7%), and 17 stents were successfully implanted. Patients were discharged about one week after PTA. Eight cases were followed up by peripheral angiograph 3～12 months after PTA. The vascular restenosis was found in 2 cases. Restenosis rate was 12.5%.
Conclusion: Endovascular stents can increase the instant success rate and decrease the restenosis rate of PTA. From our preliminary experience, stents used in peripheral arterial disease had both a good instant and long term effect., 百拇医药