| Objective:1.Observe the Cryoplasty in the treatment of lower extremity arteriosclerosis obliterans of the recent efficacy and safety; and explore the Cryoplasty experience.2. On the Cryoplasty and ordinary balloon treatment for lower extremity arteriosclerosis obliterans term efficacy and safety comparison.Materials and Methods:25 patients (27 arteries) with interventions for lower limb arterial stenosis, occlusion treatment,21 males (84%),4 females (16%), aged 63 to 89, average age (71±5.5 years).10 cases of Cryoplasty group, men 8 cases (80%), women 2 cases (representing 22%), age 66～89, average age (75.5±7.5), of which DM 9 cases (90%), hypertensive 7 cases (70%), TASC II classification:type A:7 cases (70%), type B:3 cases (30%), type C:0 cases (0%), type D:0 cases (0%); treated with 10 arteries:1 case of the external iliac artery; 8 cases of the femoral artery and 1 case of the popliteal artery; lesions length 4.3～7.8cm, an average of 6.5±0.7; ABI 0.38～0.55 average of 0.46±0.07, stenosis 80%～100% average of 91%±6%; Ordinary balloon group 15 cases, men 13 cases (86.7%), women 2 cases (13.3%), age 63～73, average age (67.9±3.5), of which DM 9 cases (60%),12 cases of hypertension (80%), TASC II classification:type A:13 cases (86.7%), type B:2 cases (13.3%), type C:0 cases (0%), type D:0 cases (0%); treated with 17 arteries:1 case of the external iliac artery; 14 cases of the femoral artery and 2 cases of the popliteal artery; lesions length 3.5～7.2cm, an average of 6.3±0.5, ABI 0.42～0.53 average of 0.48±0.06, stenosis 75%～100% average of 89%±7%.25 patients were treated with percutaneous transluminal angioplasty, Cryoplasty group operating temperature of-10℃, working pressure 6-8Bar; Ordinary balloon group with normal temperature, working pressure is 8～14Bar.Result:Cryoplasty group 10 lesions in 10 cases of interventional treatment success rate was 100%, no operative deaths, intraoperative vascular injury not occurred (such as dissection, hematoma, or bleeding), not one case of amputation occurred within 30 days, after treatment Day 2 of clinical symptoms disappeared, within 30 days after surgery without clinical symptoms in one case.day 30 after Cryoplasty change of the clinical assessment:there are 8 cases of significant improvement in 80%, moderate improvement in 2 cases,20%; after day 2 ABI 0.89～0.94 average 0.88±0.03, after day 30 ABI 0.83～0.92 average 0.84±0.04, after day 2 the degree of stenosis was 23%～31% average 27%±2%, after day 30, the degree of stenosis was 24%～34% average 29%±4%, compared with preoperative significant difference (P<0.01).Ordinary balloon group 15 cases in 17 of interventional treatment success rate was 100%, no operative deaths, one case of intraoperative dissection occurred, no other complications, not one case of amputation occurred within day 30, day 2 after treatment clinical symptoms disappeared, day 28 after treatment occurred in 1 case (6.7%) of limb paralysis;Day 30 after ordinary balloon change of the clinical assessment:there are 13 cases of significant improvement in 86.7%, moderate improvement in 2 cases,13.3%; after day 2 ABI 0.84～0.93 average of 0.86±0.06, after day 30 ABI 0.80～0.91 average of 0.84±0.05, after 2-day of Restenosis rate is 25%-34% average 30%±4%, after day 30 artery stenosis rate of 27%-36% average of 32%±4%.Cryoplasty group and ordinary balloon group before and after treatment the 30-day short-term results (such as clinical signs, ABI and ultrasound) has statistical differences (P<0.01); Cryoplasty group and ordinary balloon group temperature of two operation methods no significant difference between the effect (P= 0.55).Conclusion:Cryoplasty group treatment of arteriosclerosis obliterans are safe, effective, but the long-term effects need to follow-up. Cryoplasty group and ordinary balloon group for the treatment of arteriosclerosis obliterans between technology success rates, clinical observation of the index has no statistical differences. When use the Cryoplasty, select the appropriate balloon size, can not move the balloon when it works, balloon tail and surface is not attached water drops. |
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