经皮穿刺栓子切除术治疗急性动脉栓塞性腹股沟下血管闭塞

Schleder S, Diekmann M, Manke C, Heiss P
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引用次数: 0

摘要

背景:经皮穿刺栓子切除术(percutaneous穿刺栓子切除术,PAE)自问世以来,已成为治疗下肢缺血急性动脉栓塞性腹股沟下血管闭塞的一种众所周知、被广泛接受和经常应用的技术。目的:评价单纯经皮穿刺栓子切除术(PAE)治疗急性动脉栓塞性腹股沟下血管闭塞的技术和临床效果。材料与方法:在7年的时间里,我们发现50例患者(女性24例,48%),平均年龄73岁(53-95岁),其中54例采用PAE治疗动脉栓塞性腹股沟下血管闭塞。初级技术成功被定义为单独PAE后残余狭窄直径小于50%,二级技术成功被定义为PAE和额外的经皮腔内血管成形术(PTA)和/或支架置入术后残余狭窄直径小于50%。临床结果参数(例如,是否需要进一步干预和/或截肢)在干预后30天进行评估。结果:54例患者中46例首次手术成功率85%。二次技术成功率为96%(54例中52例)。54例患者中有50例(93%)获得临床结果数据。50例患者中有43例(86%)在干预后30天内无需进一步干预。总之,在介入后的30天内,50例患者中有5例(10%)发生了PAE截肢或死亡。结论:微创PAE是治疗急性动脉栓塞性腹股沟下血管闭塞的一种安全有效的技术。
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Percutaneous Aspiration Embolectomy in the Treatment of Acute Arterial Embolic Infrainguinal Vascular Occlusion
Background: Since its introduction, percutaneous aspiration embolectomy (PAE) has become a well-known, widely accepted and frequently applied technique for the treatment of acute arterial embolic infrainguinal vascular occlusion in lower limb ischemia.Purpose: To evaluate the technical and clinical success of sole percutaneous aspiration embolectomy (PAE) for the treatment of acute arterial embolic infrainguinal vascular occlusion.Material and Methods: During a period of 7 years, 50 patients (24 fermale, 48%) with a mean age of 73 (range 53–95) years were identified in whom 54 cases of PAE were performed for the treatment of arterial embolic infrainguinal vascular occlusion. Primary technical success was defined as residual stenosis of <50% in diameter after sole PAE, secondary technical success was defined as residual stenosis of <50% in diameter after PAE and additional percutaneous transluminal angioplasty (PTA) and/or stenting. Clinical outcome parameters (e.g. need for further intervention and/or amputation) were evaluated for the 30-day postinterventional period.Results: The primary technical success rate was 85% (46 of 54 cases). The secondary technical success rate was 96% (52 of 54 cases). Clinical outcome data were achievable in 50 of the 54 cases (93%). In 43 of the 50 patients (86%) there was no need for further intervention within the 30-day postinterventional period. In summary, during this 30-day postinterventional period after PAE amputation was carried out or death occurred in 5 of 50 patients (10%).Conclusion: Minimally invasive PAE is an effective and safe technique for the treatment of acute arterial embolic infrainguinal vascular occlusion.
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