单一的初级逆行性访问,以治疗大腿骨和尾骨闭塞性病变
Maxime Dubosq1, Régis Renard2, Jérémie Jayet1
1Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
概括
使用骨动脉的单一初级逆行通道是一种安全有效的替代方案,用于治疗股骨-骨外周动脉疾病 (PAD),即使是复杂的慢性全闭症 (CTOs). 这种方法允许快速的病人行走,具有高的技术成功和优秀的短期通透性.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 血管内干预 血管内干预
背景情况:
- 远端动脉的逆行穿刺是对周围动脉疾病 (PAD) 治疗中失败的逆行方法的救助策略.
- 关于PAD单一初级逆行访问的有效性和安全性的数据有限.
- 这项研究介绍了使用单个初级逆行通道来治疗股骨和骨PAD的结果.
研究的目的:
- 评估单一的初级逆行通道的安全性和有效性,用于治疗股骨 - 骨外周动脉疾病 (PAD).
- 评估这种方法在具有具有挑战性解剖或股骨穿刺高风险因素的患者中的可行性.
- 确定技术成功率,并发症概况和短期结果.
主要方法:
- 在2019年8月至2022年10月期间,对46名患有股骨-骨PAD的患者进行了55次手术的回顾性分析.
- 在关节水平的骨动脉的超声导向逆行穿孔,主要使用4F材料.
- 根据CTOP分类选择慢性全闭症 (CTOs);收集的人口统计,手术内和后续参数的数据.
主要成果:
- 在55个手术中,100%的技术成功率没有手术内并发症.
- 57%的患者有股骨刺穿的风险,54%的患者呈现临界肢体威胁性缺血症 (CLTI).
- 73%的后动脉被刺穿;平均手术时间为65.1分钟. 在30天后,治疗动脉的初级通透率为98%,穿孔动脉为100%.
结论:
- 一个单一的初级逆行通道是治疗股骨上骨PAD的安全有效替代方案,包括CTO.
- 这种技术促进了病人快速行走,并避免了与股骨穿刺相关的风险.
- 需要对更大种群进行进一步的前性长期研究来证实这些发现.
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