The Comparison Study Of Dual-wire Balloon Versus Ordinary Balloon In Acute Femoropopliteal Lesions

Objective: Arteriosclerosis obliterans(ASO)is a systemic desease,which originates from each artery then spreads to abdominal aorta and extremital main artery,thus causing chronic lower limb ischemia.The degree of clinical cardinal symptoms is related to the pathogenesis,the severity of arterioarctia and the compensatory ability of cerebral collateral circulation.Early symptoms include cold feelings in affected extremity,pallor and then intermittentt crippled walk.In advanced stages,skin temperature in affected extremity obviously decreases and the color is a pale white or cyanotic,along with rest pain.Distal limb shows ischemia gangrene or ulcer.Till now the real cause and pathological mechanism of ASO have not yet been fully acknowledged.Smoking,hyperlipidemia,hypertension,diabetes,adipositas,vitamin deficiency and trace element balance disorders are dangerous factors.ASO occurs most often in artery of lower extremity system and is a kind of common and multiple desease in cardiovascular surgery,which seriously reduce people's living standard.Because of its etiology and pathogenesis is not fully clear,the scholars in different view of ASO,the patient treatment have a variety of choices also.After many years of explorations and development,we have from the original era of open surgery into the era of intracavitary treatment gradually.At present,the minimally invasive interventional therapy has become the mainstream of ASO treatment.This research mainly observed the the therapeutic effitiveness and safety of regular balloon dilatation and dual-wire balloon dilatation on ASO patients with femoropopliteal artery lesion.Methods: Retrospective studies were conducted on the clinical data of 50 ASO patients with femoropopliteal artery lesion during Dec.2014 and Dec.2015.The research group and the control group.In the research group,14 patients received dual-wire balloon dilatation.In the control group,36 patients received regular balloon dilatation.25 patients(50%)had smoking history,20 patients(40%)had type ?diabetes mellitus,29 patients(58%)had hypertensive disease,15(30%)patients had combined coronary disease.11(22%)patients had combined old brain infarction.As to ASO symptoms,24(48%)patients had intermittent claudication,24(48%)had rest pain,2 patients(4%)suffered foot ulcer.Quantitate lower artery angio analysis was adopted respectively before and after surgeries to measure the minimal lumen diameter(MLD)in the abnormal parts of femoropopliteal artery,immediate pipe diameter and diameter stenosis rate.Routine examinations were improved after administration for all patients.Antiplatelet drug(Clopidogrel Hydrogen Sulphate Tablets 75mg+ Aspirin Enteric-coated Tablets 100mg)was applied immediately until the surgery.The test team: 14 patients(28%)were treated by dual-wire balloon dilatation surgery,among whom 8 patients had intermittent claudication,6 had rest pain.Abnormal length of femoropopliteal artery in the test team were 5-35(17.35±7.55 on average)cm;The diameters of saccules applied were 4 mm and 5 mm,with the length ranging between 60-150 mm.The control group: 36 patients(72%)received balloon dilatation,among whom 16 patients had intermittent claudication,18 had rest pain,2 had foot ulcer.Abnormal length of femoropopliteal artery were 3-40(16.58±10.40 on average)cm;The diameters of saccules applied were 4 mm and 5 mm,lengths ranging between 60-150 mm.After interventional surgery,ten days of 5000 iu Q12H low molecular heparin were used for anticoagulant therapy.Three months of antiplatelet drugs(Clopidogrel Hydrogen Sulphate Tablets 75mg+ Aspirin Enteric-coated Tablets 100mg)were taken orally by all patients after operations and Aspirin Enteric-coated Tablets will maintain for their lifetime.Meanwhile,we observe patient at the clinical symptoms improved in the near future(a month after the operation)and the follow-up.Results:1 Diameter stenosis rates in the test group were significantly lower [(14.97±6.11)vs.(23.39±10.82)%,P<0.05].Minimal lumen diameter was larger [(3.96±0.45)vs.(3.61±0.51)mm,P<0.05].Immediate pipe diameter was larger [(2.69±0.69)vs.(2.08±0.87)mm,P<0.05].The difference was significant.The therapeutic effect of dual-wire balloon dilatation was significantly better than that of regular balloon dilatation(P<0.05).2 The total effective rates(The number of cases in patients with clinical improvement and clinical remission/Total number of cases each group patients)of both groups were respectively 100% and 97.2%,short-term effects of both groups have no significant difference.3 After 6.7months follow-up,the total effective rates(The number of cases in patients with clinical improvement and clinical remission/Total number of cases each group patients)were respectively 100% and 88.9%,and the difference is significant.Conclusion:1 During the treatment of lower limb ischemia caused by femoropopliteal artery lesion,dual-wire balloon does better in exerting instant expansionary effect compared to regular balloon.2 No significant difference shows between dual-wire balloon and regular balloon in short-term therapeutic effect during the treatment.3 The follow-up results showed that the therapeutic effect of dual-wire balloon is obviously superior to that of regular balloon.