| 摘要: |
| 目的 探讨超声在下肢动脉定向斑块旋切术中的临床应用价值。方法 选取46例股腘动脉狭窄患者（狭窄程度＞70%，病变长度＜5 cm），随机分为超声+DSA组（术中超声定位斑块，DSA下切除斑块）和DSA组（DSA下切除斑块），每组各23例，分别行定向斑块旋切术，比较两组在DSA评估和超声评估下技术成功率及病变管腔残余狭窄率（RSR）。术后随访1年，比较两组踝肱指数、RSR、收缩期峰值流速比（PSVR）及一期通畅率。结果 超声+DSA组和DSA组在DSA评估下技术成功率（RSR≤30%）均为100%，而超声评估下技术成功率分别为100%和39.1%（P＜0.01）；术后超声评估两组RSR分别为（24.4±2.1）%和（38.7±4.6）%，差异有统计学意义（P＜0.01）。术后随访1年，超声+DSA组踝肱指数、RSR、PSVR均显著优于DSA组，差异均有统计学意义（均P＜0.01）。超声+DSA组一期通畅率为78.3%，显著高于DSA组47.8%，差异有统计学意义（P=0.032）。结论 在定向斑块旋切术治疗股腘动脉短段狭窄/闭塞病变时，增加超声辅助可提高管腔获得，提高临床疗效。 |
| 关键词: 超声检查 股腘动脉病变 定向斑块旋切术 |
| DOI： |
| 投稿时间：2019-05-08修订日期：2019-05-28 |
| 基金项目: |
|
| Usefulness of ultrasonography during directional atherectomy for lower extremity artery stenosis/occlusive lesions |
| ye xiao ping,wang jing |
| () |
| Abstract: |
| Objective To evaluate the usefulness of ultrasonography（USG） during directional atherectomy（DA） for lower extremity artery stenosis/occlusive lesions. Methods Forty-six patients with femoropopliteal artery stenosis/occlusive lesions（＞70% stenosis, ＜5 cm in length）were included. The patients were randomly assigned into USG+DSA group（the precise location of plaque was identified by USG，and the plaque was removed under DSA subsequently）and DSA group（the plaque was removed under DSA）, each group had 23 cases. The procedural success rate on USG and DSA and the residual stenosis rate（RSR） between the two groups were compared immediately. Postoperative outcomes，such as ankle brachial index（ABI），RSR，peak systolic velocity ratio（PSVR） and primary patency rate were compared one year post operation. Results The procedural success rate was 100% on DSA in both groups. For USG evaluation，the procedural success rate of USG+DSA group was 100%，but only 39.1% for DSA group（P＜0.01）. The RSR after DA was（24.4±2.1）% and（38.7±4.6）% respectively，and the difference was statistically significant（P＜0.01）. One year after treatment，the patients in USG+DSA group showed significantly improvement in ABI, RSR and PSVR than those in DSA group（all P＜0.01）. The primary patency rate of USG+DSA group（78.3%） was higher than that of DSA group（47.8%）, and the difference was statistically significant（P=0.032）. Conclusion Intraoperative USG during DA might increase the acquirement of lumen, and is an effective and safe treatment option for short segment occlusive lesions of the femoropopliteal artery. |
| Key words: Ultrasonography Femoropopliteal artery lesions Directional atherectomy |
