| Lower limb arteriosclerosis obliterans (ASO) is a clinical common peripheral vascular disease. In recent years, ASO incidence is increased, which is accompanied with the improvement of living standards and aging problems. There are many methods to treat the ASO but all have shortcomings, conventional conservative treatment efficacy is not ideal, surgical treatment with big trauma, complications and higher postoperative restenosis problems. Along with the development of molecular biology and medicine gene therapy and stem cell transplantation for ASO gained extensive and in-depth research are applied to clinic, large sample clinical data is still lacked. Endovascular treatment, with its unique advantages of smaller trauma, higher security, simple operation and faster postoperative recovery, is patient and doctor's best choice.Objective:Summary experience of Endovascular treatment of iliac femoral artery arteriosclerosis obliterans (ASO), by reviewing 62 patients who diagnosed with lower extremity arterial occlusion, hospitalized between October 2008 and December 2010, follow-up 2 years, evaluation cavity Interventional treatment of ASO's reliability and validity. Compare with the cumulative patency rate of different groups, different lesions, different types and various risk factors on the rate of vascular occlusion.Methods:This study selected the China-Japanese Union Hospital, Jilin University, two of Vascular Surgery October 2008 to December 2010 the hospital diagnosed patients with lower extremity arterial occlusive disease of 62 patients (77 limbs) of the complete history of data and related follow-up data research, analyze the ABI before and after surgery, the cumulative patency rates of various groups, clinical symptoms, postoperative complications were observed including: All patients were followed up for the cumulative patency rate; by calculating the different lesions, different cumulative patency rate of each type to compare whether statistically significant differences; surgical complications and clinical symptoms; a variety of combined risk factors on the risk of vascular occlusion rate of significance. Application SPSS17.0 package all the data were statistically treated. Measurement data to x±s, both the number of significance tests using T test, frequency distribution using X~2 test. Kaplan-Meier method to calculate the cumulative patency rate. Risk factors were analyzed by Logistic regression analysis. P <0.05 as significantly different, P <0.01 as statistically significant difference.Results:1. All limbs mean preoperative ABI 0.36±0.10, after increased to 0.74±0.21, comparison between the two P <0.01, there was statistically significant. 2. All the limbs are used balloon expandable stent implantation, after 3 months, 6 months, 12 months, 18 months, 24 months, the cumulative patency rate was 94.8%, 86.3%, 73.4% 66.1%, 62.8%. 3. In which the iliac artery after 3 months, 6 months, 12 months, 18 months, 24 months, the cumulative patency rate was 100%, 95.8%, 89.8%, 82.9%, 82.9%; femoral artery disease cumulative patency rate was 92.2%, 81.4%, 65.1%, 57.2%, 52.0%. Iliac artery, the cumulative patency rate is higher than the femoral artery segment between the two P = 0.023, was statistically significant. 4. TASC A, B-type lesions and C, D lesions compared cumulative patency, 3 months, 6 months, 12 months, 18 months, 24 months, the former patency rate was 100%, 100%, 90.5% , 84.5%, 84.5%, which was 90.5% and 75.4%, 60.6%, 53.0%, 48.2%. Patency rate of the former to the latter, P = 0.003 between the two are statistically significant. 5. The total complication rate was 9.68%, hematoma formation 3.23%, lower extremity arterial thrombosis 4.84%, contrast medium association nephropathy 1.61%. Hematoma occur in 2 cases, lower extremity arterial thrombosis occur in 3cases; contrast medium association nephropathy occur in 1cases. No artery sandwich, artery rupture, pseadoaneurusm, arteriovenous fistula, the vagus nerve reflection, deep venous thrombosis cases. After 75 physical symptoms, the clinical success rate was 97.40%. 6. Regression analysis of relevant risk factors, diabetes, smoking history, P <0.05, indicating that with the reconstruction of vascular occlusion related.Conclusions:1. Endovascular treatment is the preferred treatment of iliac and femoral arteriosclerosis stenosis and short occlusion.2. Iliac artery lesions cumulative patency rate is higher than the femoral artery segment.3. TASCⅡA, B-type is much more damaged than C, D lesions cumulative patency rate.4. For the patients who are elderly, with poor condition of local vascular or with more plaques, cutting and puncture under direct vision would be safe and effective way to reduce complications.5. Pay attention to the risk factors of contrast medium associated nephropathy and hyration after endovascular treatment.6. Diabetes and smoking are the risk factors in this disease. |
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