| Objective To compare the procedure of percutaneous endovascular angioplasty and stent implanting for the patients diagnosed with arteriosclerosis obliterans.Methods The general data,preoperative examination and postoperative index data of patients with lower extremity arteriosclerosis obliterans hospitalized in the Department of Vascular Surgery of our hospital from May 2017 to May 2019 were collected and analyzed retrospectively.We split the 164 limbs(158 patients)into 76 limbs with percutaneous endovascular angioplasty and 88 limbs with stent implanting,we called PTA and stent group in the following text.Compare technique success,operation time,intraoperative complications,postoperative clinical success rate and postoperative ankle brachial index(ankle brachial index,ABI)improvement,postoperative complications(including amputation and death during hospital stay)and followed up for 1 year target lesion revascularization,limb-salvage rate,survival rate,primary and second patency rate of two groups.Then,according to the target vessel of the stent implanted,the stent group were subdivided into the aortoiliac artery and femoropopliteal artery subgroups to compare the postoperative efficacy of single stent implantation and multiple stents implantation in the same target vessel.Results(1)The baseline characteristics between groups were comparable,showed no statistical differences between the two groups(P > 0.05).(2)Comparison of intraoperative indicators: there was no significant difference in the technical success rate between the PTA group and the stent group(P>0.05).In terms of intraoperative complications,case of dissection in the stent group is much more compared with PTA group(P<0.05).Speaking of the operation time,it was definitely longer in the stent group(P>0.05).(3)Clinical success rate,also called improvement rate,postoperative ABI value,perioperative complications,amputation and mortality,and hospital stay time in the two groups: stent group achieve more clinical success than the PTA group(P<0.05).Postoperative ABI in both groups has a large improvements compared to preoperative ABI(P<0.05),but there was no big difference in postoperative ABI between groups(P>0.05).Incidence of perioperative complications,perioperative mortality and hospital stays were found no differences(P>0.05).(4)Comparison of postoperative efficacy between the PTA group and the stent group:159 limbs were followed,follow-up time range from 1 month to 12 month.Follow-up time was comparable(P>0.05).The TLR of the PTA group and the stent group at 3rd,6th,and 12 th months after surgery were 8.3%s 0%,7.6%vs4.9%,and 7.8%vs7.7%respectively.The limb salvage rates were 95.8%vs100%,98.5%vs100%,100%vs100%;The survival rates were 97.3%vs97.7%,98.6%vs97.6%,95.8%vs95.1% respectively.The primary patency rate was 91.8%vs98.8%,92.5%vs93.9%,92.3%vs92.3%.The secondary patency rate of 12 th months was98.3%vs98.7%.PTA group tended to have higher TLR rate than the stent group(P<0.05),no statistical difference found in terms of other indicators(P>0.05).The stent group achieve better one-year cumulative patency rate than PTA group(P <0.05).(5)In the stent group,there were no significant differences in TLR,limb salvage rate and survival rate at 12 th months after implantation of single or multiple stents in the aortoiliac artery and femoropopliteal artery subgroups(P > 0.05).Conclusions For the patients with lower extremity arteriosclerosis occlusive disease,endovascular intervention has its safety and short-term efficacy.In this study,the stent group achieved higher postoperative clinical success rate than PTA group,the stent group had less TLR cases at the 3rd month.However,no significant differences were found in other postoperative follow-up efficacy between the two groups.The efficacy of a single stent implantation in the same target vessel for lower extremity arteriosclerosis obliterans patients’ 12 th months after surgery was not inferior to that of multiple stents implantation. |
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