Clinical Effects Of Femoral Artery Thrombectomy Combined With DCB In The LEASO With Acute Arterial Thrombosis

Objective:To analyze the clinical efficacy and complication rate of femoral artery thrombectomy combined with Drug-coated balloon(DCB)and single femoral artery thrombectomy in the treatment of acute arterial thrombosis in patients with Lower extremity arteriosclerosis obliterans(LEASO),to provide clinical data for the treatment of LEASO with acute arterial thrombosis.Method:The clinical data of 55 LEASO patients with acute arterial thrombosis admitted to the affiliated hospital of Yanbian University from January 2015 to January 2020 were analyzed retrospectively.The patients were divided into two groups according to the treatment.among them,30 cases were divided into control group and 25 cases into Observation Group.All patients underwent color doppler ultrasound,computed tomography angiography(CTA)and other imaging examinations,the typical clinical manifestations,such as intermittent claudication,rest pain,gangrene,and “6P sign”,are present in patients with the disease,which accumulates above the popliteal artery,preoperative and postoperative 7 days,3 months,6 months,12 months Ankle brachial index(ABI),preoperative and postoperative 1 month limp distance,preoperative and postoperative 3 months,6 months and 12 months Fontaine stage were recorded,the primary vascular patency rate and perioperative complication rate were compared in terms of safety and postoperative effect.Results:1.There was no significant difference between the two groups in age,sex,ABI before operation,distance of Claudication,Fontaine stage,smoking or not,and other diseases(hypertension,diabetes,cerebral infarction and coronary heart disease)(P >0.05).2.The ABI after operation in the Observation Group and the control group were0.83 ± 0.01 vs 0.73 ± 0.01 in 7 days,0.8 ± 0.02 vs 0.68 ± 0.018 in 3 months,0.74 ± 0.01 vs 0.63 ± 0.01 in 6 months,0.68 ± 0.01 vs 0.57 ± 0.01 in 12 months,a BI in both groups increased significantly at 7 days postoperatively,but decreased significantly during the follow-up period(f = 2023.5,3458.59;p < 0.01),especially in the control group.There were significant differences among pre-operation,3 months,6 months and 12 months(Q = 8.39 ～ 145.34,p < 0.05).3.The claudication distance was(148.4 ± 19.08)m before operation and(404.8 ± 26)m one month after operation in the observation group,and(141.67 ±14.87)m before operation and(337 ± 15.12)m one month after operation in the control group.The claudication distance of the two groups increased 1 month after operation,the difference was statistically significant(p < 0.05),but the observation group increased more than the control group.4.The Fontaine stage of 3,6 and 12 months after operation in the Observation Group and the control group were compared between the two groups,and the difference was statistically significant(p < 0.05).5.The primary vascular Patency rates of the two groups at 3,6 and 12 months were 96% and 83%,88% and 66%,76% and 46%;respectively,and there was no significant difference between the two groups(P > 0.05).The patency rate of blood vessels at 12 months after operation was statistically significant(P < 0.05).6.Complications were observed in 5 cases,hematoma in 3 cases(12%),incision infection in 2 cases(8%),and ischemic reperfusion injury in 1 case(4%).In the control group,there were 11 complications,4 hematoma(13.3%),1 wound infection(3.3%),4 ischemic reperfusion injury(13.3%),1 renal dysfunction(3.3%),and 1osteofascial compartment syndrome(3.3%).There was no significant difference in the incidence of complications between the observation group and the control group(P >0.05).Conclusions:Femoral artery thrombectomy combined with DCB in the treatment of LEASO with acute arterial thrombosis is more reliable,safe and effective than femoral artery thrombectomy in ABI,lameness distance,Fontaine stage and primary patency rate.