The Application Of Endovascular Treatment In Lower Extremity Arteriosclerosis Obliterans Report Of 50 Cases

Objective:To evaluate the short term effct and complications together with therapy and prevention of endovascular treatment in patients with lower extremity arteriosclerosis obliterans(ASO).Methods:we conducted a retrospective analysis on 50 patients of lower extremity arteriosclerosis obliterans. Underwent endovascular treatment from June 2008 to December 2010 in the vascular department ofChina Japan union Hospital of Jilin University.According to TransAtlantic Inter-Society Consensus(TASC) staging and the lesions of the vascular,50 patients(60 limbs) were treated with endovascular therapy . Clinical symptoms,ankle-brachial index(ABI)and Transcutaneous oxygen pressure(TcPO₂) were evaluated before and after the treat- ment.statistical software packages was used in data collation of the ABI and TcPO₂ as a statistical method, P<0.05These were significant differences;and prevention of complications were also analyzed.Results:In the 50 patients underwent endovascular treatment,the total acute patency rate was 90.9%,technical success rate was 92.8%.The amount of succeded limbs of endovascular treatment was 56,52 limbs gained improvement with different degree,2 limbs gained no changes,1 limb was amputated infrapopliteal,1 patient died of acute myocardial infarction .The perioperative complication rate was 16%.Ankle brachial index(ABI) of postoperation is 0.71±0.21 and preoperation is 0.28±0.13,there was significant improvement and different procedure.Transcutaneous oxygen pressure(TcPO₂)of postoperation is 45.12±13.43(mmHg) and preoperation is 25.11±8.70(mmHg),there was significant improvement and different procedure.Patients were followed up from 3-30 months.The 3-month,6-month,1-year and 2-year primary patency of the iliac artery was 100%,100%,92.8% and 83.3%.the primary patency of the femoropopliteal (superficial femoral)artery was 83.3%,71.4%,53.8% and 44.4%,the secondary patency was 86.7%,76.2%,69.2 and 55.5%. The 3-month,6-month primary patency of the infrapopliteal artery was 62.5%,50%.Conclusions:1 Endovascular treatment for iliac medal occlusive disease has a better effect ,and it can be used as the first choice.2 Endovascular treatment is a safe and effective method for femoropopliteal arterial occlusive disease,and can gain a satisfactory short term effect,But as to the long term ,we need do some further study in the future.It is preferential in patients with critical limb ischemia especially.3 Endovascular treatment is a safe and effective method for the infrapopliteal arterial occlusive disease,and can gain a better short term effect.The main objective is to raise the salvage rate of limbs and the survival rate.The Percutaneous transluminal angioplasty(PTA) is preferential,especially in the diabetes patients with critical limb ischemia.