Curative Effect Analysis Of Interventional Treatment Of Long Block Type Femoropopliteal Artery

Objective:The incidence of the lower limb atherosclerosis obliterans is higher and higher. Femoropopliteal artery is the most commonly affected. With the rapid development of interventional treatment technology and intervention therapy equipment, the scope and interventional treatment efficacy have the very big improvement of ASO. The interventional treatment is being increasingly used to Long Block Type Femoropopliteal Artery witch is belong to the type TASC II C,D. This study summarized the clinical datas of Long Block Type Femoropopliteal Artery who accepted interventional treatment, and analyzed the success rate of interventional treatment, patency and complications, and summarized the clinical curative effect.Materials and methods: Collect the clinical datas of 29 cases(32 limbs) Long Block Type Femoropopliteal Artery who accepted interventional treatment, belonged to the interventional therapy department of the union hospital affiliated to Fujian medical university from January 2010 to February 2016. Include type TASC II C 17 limbs and D 15 limbs, the main performance included, 23 limbs skin temperature reduced, and 12 limbs myodynamia decreased, and 19 limbs had intermittent claudication, and 14 limbs had rest pain, and 6 limbs had ulceration, etc. Used local infiltration anesthesia, and selected the road into the artery basing on the preoperative imaging information. Acrossing the occlusion lesion with the catheter and thread, and confirmed by angiography that it was true cavity. Expanded the occlusion lesion from distal to the proximal with different diameter and length of the balloon according to the situation of lesion vessels. After expansion, if residual stenosis was greater than 30% or had an sandwich impact on blood flow, we placed stents.Result: Treatment success rate is 100%(32/32), and 9 limbs received PTA, and 23 limbs received PTAS. The length of lesion is 16 to 36 centimeter(an average of 21.25 centimeter). Imagine showed that distal of deep artery and femoropopliteal artery had formed the large amount of collateral. After interventional treatment,the ischemia symptoms of most limbs improved immediately. 23 limbs' skin temperature increased, and 11 limbs' muscle strength improved,and 19 limbs' distance of intermittent claudication is extended,and 14 limbs' rest pain disappeared, and 4 limbs' ulcers reduced, 2 limbs' ulcer healed. Foot artery ankle brachial index was 0.18 ± 0.12 preoperatively and 0.69 ± 0.20 3 days after interventional treatment, the difference was statistically significant(P <0.05). 3 limbs appeared artery perforation. 1 limb appeared femoral artery puncture point bleeding and subcutaneous hematoma postoperative. 1 patient died during perioperative due to severe systemic infection with bedridden. We followed up the 26 patients(29 limbs), and lost 2 patients(2 limbs). The follow up rate was 92.9%(26/28). The follow-up period was from 1 to 66 months(an average of 34 ± 19 months). 1 patient(1 limb) was amputated above the knee in local hospital dued to rest pain and toe gangrene after 2 months. 13 patients(16 limbs) had complete remission of symptoms(reach anatomical improvement), and 8 patients(8 limbs) improved(achieve clinical improvement), and 3 patients(3 limbs) had no significant improvement. 1 patient(1 limb) died of severe coronary heart disease and cerebrovascular accidents related to non surgical complications. 3 limbs respectively recurrenced in 6,10,16 months. 1 limb re-occlusion occurred within the stented segment in 9,29 months, and it was revascularized within local intra arterial thrombolysis or placed stents. A patency rate was 69.0%(20/29). Recurrence rate was 13.8%(4/29). Secondary graft patency was 79.3%(23/29). Limb salvage rate was 96.9%(28/29).Conclusion: Interventional treatment of Long Block Type Femoropopliteal Artery is effective and safe. With the progress of interventional treatment technology and the rapid development of interventional therapy equipment, curative effect is improving. With a lower incidence of surgical complications, interventional treatment has evident efficacy and very good prospects.