| Objectives:The objective of this this retrospective study is to collect medical records and postoperative follow-up data from patients with TASC II C and D femoropopliteal lesions who was treated by endovascular treatment,to summarize experience and skills of endovascular treatment for patients and to explore the clinical efficacy and the related risk factors of restenosis after endovascular treatment.Providing the basis for this kind of choice way.Methods:Clinical data of patients diagnosed with TASC II C and D femoropopliteal lesions who treated endovascular treatment from The First Affiliated Hospital of Xiamen University in hospital,including perioperative clinical symptoms,the related risk factors,test and inspection data,surgical treatment and follow-up data.Assessing the technical success rate,changes in ABI,improvement in clinical symptoms,perioperative complications,primary patency rate at 1,3,6,12,18,24 months,and secondary patency rate at 12 and 24 months.The evaluation the related risk factors of restenosis after endovascular treatment was used Cox regression model.Result:In this group of 37 patients(42 limbs)with TASC II C and D femoropopliteal lesions,36 patients(41 limbs)were successfully opened.17 limbs were opened with true lumen and 24 limbs were opened with SIA technology.The technical success rate was 97.62 %(41/42).9 limbs lesions were treated by percutaneous transluminal angioplasty and 32 limbs lesions were treated by stenting combined PTA.A total of 63 stents were implanted,all of which were bare stents.The Rutherford 7 grading method showed that the postoperative clinical improvement rate of 42 affected limbs was 97.62%(41/42).Ankle-brachial index(ABI)of the limb was 0.87±0.30 at 1 week after surgery,significantly higher than that before surgery(0.45±0.18),and the difference was statistically significant(P<0.001).The total incidence of postoperative complications was 16.67%.No perioperative death was found.The patients were followed up for 5 to 24 months,and the median follow-up time was 19.0 months.The primary patency rates were 100%,97.56%,85.00%,64.86%,54.29% and 36.36% at 1,3,6,12,18,24 months.Survival analysis showed no significant difference in postoperative survival between type C and type D(P>0.05),and no significant difference in survival between IC and CLI groups(P>0.05).During the follow-up,there were 21 cases of postoperative restenosis of the affected limbs,among which 14 cases were treated again with thrombolysis,PTA,TAPAS catheter and stent implantation,and 11 cases were successfully opened.The secondary patency rate was 78.38% and 66.67% at 12 months and 24 months after surgery.The salvage rate was 84.85% at 2 years after operation.Cox regression analysis showed that smoking and diabetes were risk factors for postoperative stenosis recurrence.Conclusions: 1?Under the skills of endovascular therapy,the treatment of TASCII C and D femoropopliteal lesions have higher success rate,lower limb ischemia symptoms improve,ABI rise.Although the rate of primary patency is slightly lower than that of traditional surgery reported in a large number of literatures,the rate of secondary patency is similar and Short and medium term curative effect is satisfactory.Due to minimally invasive,less complications,high safety,Endovascular therapy can be used as TASCII C and D femoropopliteal lesions effective method of treatment.2?The use of thrombolysis,PTA,TAPAS catheter and stent implantation in the postoperative restenosis of the affected limb can contribute to the successful opening of the stenosis vessels,thus saving the limb with good repeatability.The short-term efficacy is satisfactory and the long-term patency rate needs further follow-up.3?Smoking and diabetes are the main risk factors for postoperative restenosis.Strict smoking cessation and diabetes control are helpful to improve the efficacy. |
PDF Full Text Request