切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 76 -80. doi: 10.3877/cma.j.issn.1674-0793.2020.01.023

所属专题: 文献

综述

下肢动脉支架内再狭窄的诊断和治疗
毛由军1, 李晓强2,()   
  1. 1. 213000 常州,南京医科大学附属常州第二人民医院血管外科
    2. 210008 南京,南京大学医学院附属鼓楼医院血管外科
  • 收稿日期:2019-10-12 出版日期:2020-02-01
  • 通信作者: 李晓强

Diagnosis and treatment of in-stent restenosis of lower extremity artery

Youjun Mao1, Xiaoqiang Li2,()   

  1. 1. Department of Vascular Surgery, Changzhou No.2 People’s Hospital, the Affiliated Hospital of Nanjing Medical University, Changzhou 213000, China
    2. Department of Vascular Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
  • Received:2019-10-12 Published:2020-02-01
  • Corresponding author: Xiaoqiang Li
  • About author:
    Corresponding author: Li Xiaoqiang, Email:
引用本文:

毛由军, 李晓强. 下肢动脉支架内再狭窄的诊断和治疗[J/OL]. 中华普通外科学文献(电子版), 2020, 14(01): 76-80.

Youjun Mao, Xiaoqiang Li. Diagnosis and treatment of in-stent restenosis of lower extremity artery[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(01): 76-80.

随着人口老龄化的加重,下肢动脉狭窄与闭塞性疾病的发生率越来越高,同时伴随着腔内支架的广泛应用,支架内再狭窄的发生率也逐渐升高。目前治疗支架内再狭窄的技术主要有药物治疗、普通球囊、药涂球囊、金属裸支架、药物洗脱支架、腔内减容(激光、旋切)和旁路搭桥术等。单一治疗方法效果均有限,而腔内减容与药涂球囊联合既可以机械去除增生的内膜,又可以有效抑制内膜再增生,是目前治疗支架内再狭窄较为合理的方法。

With the aging of the population, the incidence of lower extremity arterial stenosis and occlusive disease is getting higher and higher, and the endovascular stents have been widely used, thus the incidence of in-stent restenosis is also increasing. At present, the techniques used for the treatment of ISR include drug therapy, plain balloon, drug-coated balloon, bare-metal stent, drug-eluting stent, intracavity volume reduction (laser atherectomy, excisional atherectomy) and bypass surgery. The effects of single treatment methods are limited, and intracavitary volume reduction combined with drug-coated balloon can mechanically remove the proliferating intima and effectively inhibit the intimal hyperplasia, which is a reasonable method for the treatment of in-stent restenosis.

表1 股腘动脉支架内再狭窄(FPA-ISR)分型
[1]
Rymer JA, Jones WS. Femoropopliteal in-stent restenosis[J]. Circ Cardiovasc Interv, 2018, 11(12): e007559.
[2]
Zhao LP, Xu WT, Wang L, et al. Influence of insulin resistance on in-stent restenosis in patients undergoing coronary drug-eluting stent implantation after long-term angiographic follow-up[J]. Coron Artery Dis, 2015, 26(1): 5-10.
[3]
Conte MS, Pomposelli FB, Clair DG, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication[J]. J Vasc Surg, 2015, 61(3 Suppl): 2S-41S.
[4]
Zheng H, Calligaro KD, Jang J, et al. Duplex ultrasound for diagnosis of failing stents placed for lower extremity arterial occlusive disease[J]. Ann Vasc Surg, 2019. [Epub ahead of print]
[5]
Garcia-Guimaraes M, Antuña P, Maruri-Sanchez R, et al. Calcified neoatherosclerosis causing in-stent restenosis: prevalence, predictors, and implications[J]. Coron Artery Dis, 2019, 30(1): 1-8.
[6]
Luo H, Zhou C, Chi J, et al. The role of tauroursodeoxycholic acid on dedifferentiation of vascular smooth muscle cells by modulation of endoplasmic reticulum stress and as an oral drug inhibiting in-stent restenosis[J]. Cardiovasc Drugs Ther, 2019, 33(1): 25-33.
[7]
Kim W, Choi D. Treatment of femoropopliteal artery in-stent restenosis[J]. Korean Circ J, 2018, 48(3): 191-197.
[8]
Elmahdy MF, Buonamici P, Trapani M, et al. Long-term primary patency rate after nitinol self-expandable stents implantation in long, totally occluded femoropopliteal (TASC Ⅱ C & D) lesions[J]. Heart Lung Circ, 2017, 26(6): 604-611.
[9]
Wang J, Jin X, Huang Y, et al. Endovascular stent-induced alterations in host artery mechanical environments and their roles in stent restenosis and late thrombosis[J]. Regen Biomater, 2018, 5(3): 177-187.
[10]
Tosaka A, Soga Y, Iida O, et al. Classification and clinical impact of restenosis after femoropopliteal stenting[J]. J Am Coll Cardiol, 2012, 59(1): 16-23.
[11]
Iida O, Yokoi H, Soga Y, et al. Cilostazol reduces angiographic restenosis after endovascular therapy for femoropopliteal lesions in the sufficient treatment of peripheral intervention by cilostazol study[J]. Circulation, 2013, 127(23): 2307-2315.
[12]
Iftikhar O, Oliveros K, Tafur AJ, et al. Prevention of femoropopliteal in-stent restenosis with cilostazol: A Meta-analysis[J]. Angiology, 2016, 67(6): 549-555.
[13]
Kinstner CM, Lammer J, Willfort-Ehringer A, et al. Paclitaxel-eluting balloon versus standard balloon angioplasty in in-stent restenosis of the superficial femoral and proximal popliteal artery: 1-year results of the PACUBA trial[J]. JACC Cardiovasc Interv, 2016, 9(13): 1386-1392.
[14]
Dick P, Sabeti S, Mlekusch W, et al. Conventional balloon angioplasty versus peripheral cutting balloon angioplasty for treatment of femoropopliteal artery in-stent restenosis: initial experience[J]. Radiology, 2008, 248(1): 297-302.
[15]
Shin SH, Baril DT, Chaer RA, et al. Cryoplasty offers no advantage over standard balloon angioplasty for the treatment of in-stent stenosis[J]. Vascular, 2013, 21(6): 349-354.
[16]
Bague N, Julia P, Sauguet A, et al. Femoropopliteal in-stent restenosis repair: midterm outcomes after paclitaxel eluting balloon use (PLAISIR Trial)[J]. Eur J Vasc Endovasc Surg, 2017, 53(1): 106-113.
[17]
Grotti S, Liistro F, Angioli P, et al. Paclitaxel-eluting balloon vs standard angioplasty to reduce restenosis in diabetic patients with in-stent restenosis of the superficial femoral and proximal popliteal arteries: three-year results of the DEBATE-ISR study[J]. J Endovasc Ther, 2016, 23(1): 52-57.
[18]
Liistro F, Angioli P, Porto I, et al. Paclitaxel-eluting balloon vs. standard angioplasty to reduce recurrent restenosis in diabetic patients with in-stent restenosis of the superficial femoral and proximal popliteal arteries: the DEBATE-ISR study[J]. J Endovasc Ther, 2014, 21(1): 1-8.
[19]
Krankenberg H, Tubler T, Ingwersen M, et al. Drug-coated balloon versus standard balloon for superficial femoral artery in-stent restenosis: the randomized femoral artery in-stent restenosis (FAIR) trial[J]. Circulation, 2015, 132(23): 2230-2236.
[20]
Thukkani AK, Kinlay S. Endovascular intervention for peripheral artery disease[J]. Circ Res, 2015, 116(9): 1599-1613.
[21]
Tomoi Y, Soga Y, Iida O, et al. Impact of drug-eluting stent implantation for femoropopliteal in-stent occlusion[J]. J Endovasc Ther, 2016, 23(3): 461-467.
[22]
Dake MD, Ansel GM, Jaff MR, et al. Sustained safety and effectiveness of paclitaxel-eluting stents for femoropopliteal lesions: 2-year follow-up from the Zilver PTX randomized and single-arm clinical studies[J]. J Am Coll Cardiol, 2013, 61(24): 2417-2427.
[23]
Bosiers M, Deloose K, Callaert J, et al. Superiority of stent-grafts for in-stent restenosis in the superficial femoral artery: twelve-month results from a multicenter randomized trial[J]. J Endovasc Ther, 2015, 22(1): 1-10.
[24]
Gorgani F, Telis A, Narakathu N, et al. Long-term outcomes of the Viabahn stent in the treatment of in-stent restenosis in the superficial femoral artery[J]. J Invasive Cardiol, 2013, 25(12): 670-674.
[25]
Werner M. Bioresorbable scaffolds for the SFA: new developments[J]. J Cardiovasc Surg (Torino), 2014, 55(4): 455-459.
[26]
Shammas NW, Shammas GA, Aasen N, et al. Number of blades-up runs using jetstream XC atherectomy for optimal tissue debulking in patients with femoropopliteal artery in-stent restenosis[J]. J Vasc Interv Radiol, 2015, 26(12): 1847-1851.
[27]
Schmidt A, Zeller T, Sievert H, et al. Photoablation using the turbo-booster and excimer laser for in-stent restenosis treatment: twelve-month results from the PATENT study[J]. J Endovasc Ther, 2014, 21(1): 52-60.
[28]
Dippel EJ, Makam P, Kovach R, et al. Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: initial results from the EXCITE ISR trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis)[J]. JACC Cardiovasc Interv, 2015, 8(1 Pt A): 92-101.
[29]
Armstrong EJ, Thiruvoipati T, Tanganyika K, et al. Laser atherectomy for treatment of femoropopliteal in-stent restenosis[J]. J Endovasc Ther, 2015, 22(4): 506-513.
[30]
Shammas NW, Shammas GA, Jerin M. Differences in patient selection and outcomes between SilverHawk atherectomy and laser ablation in the treatment of femoropopliteal in-stent restenosis: A retrospective analysis from a single center[J]. J Endovasc Ther, 2013, 20(6): 844-852.
[31]
Brodmann M, Rief P, Froehlich H, et al. Neointimal hyperplasia after silverhawk atherectomy versus percutaneous transluminal angioplasty (PTA) in femoropopliteal stent reobstructions: A controlled, randomized pilot trial[J]. Cardiovasc Intervent Radiol, 2013, 36(1): 69-74.
[32]
Beschorner U, Krankenberg H, Scheinert D, et al. Rotational and aspiration atherectomy for infrainguinal in-stent restenosis[J]. Vasa, 2013, 42(2): 127-133.
[33]
van den Berg JC, Pedrotti M, Canevascini R, et al. In-stent restenosis: mid-term results of debulking using excimer laser and drug-eluting balloons: sustained benefit?[J]. J Invasive Cardiol, 2014, 26(7): 333-337.
[34]
Kokkinidis DG, Hossain P, Jawaid O, et al. Laser atherectomy combined with drug-coated balloon angioplasty is associated with improved 1-year outcomes for treatment of femoropopliteal in-stent restenosis[J]. J Endovasc Ther, 2018, 25(1): 81-88.
[35]
Sixt S, Carpio Cancino OG, Treszl A, et al. Drug-coated balloon angioplasty after directional atherectomy improves outcome in restenotic femoropopliteal arteries[J]. J Vasc Surg, 2013, 58(3): 682-686.
[36]
Milnerowicz A, Milnerowicz A, Kuliczkowski W, et al. Rotational atherectomy plus drug-coated balloon angioplasty for the treatment of total in-stent occlusions in iliac and infrainguinal arteries[J]. J Endovasc Ther, 2019, 26(3): 316-321.
[37]
Nolan BW, De Martino RR, Stone DH, et al. Prior failed ipsilateral percutaneous endovascular intervention in patients with critical limb ischemia predicts poor outcome after lower extremity bypass[J]. J Vasc Surg, 2011, 54(3): 730-735.
[38]
Bradbury AW, Adam DJ, Bell J, et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial: analysis of amputation free and overall survival by treatment received[J]. J Vasc Surg, 2010, 51(5 Suppl): 18S-31S.
[1] 杨城, 李祖儿, 刘青, 赵渊, 徐崇燕, 苏军, 张文云. 新型三维复合骨修复支架的制备工艺及其生物学性能[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(04): 219-229.
[2] 徐逸男. 不同术式治疗梗阻性左半结直肠癌的疗效观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 72-75.
[3] 康婵娟, 张海涛, 翟静洁. 胰管支架置入术治疗急性胆源性胰腺炎的效果及对患者肝功能、炎症因子水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 667-670.
[4] 李佳伟, 庞建智, 闫鹏宇, 卫阳兵, 杨晓峰. 术中输尿管识别技术研究进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 520-524.
[5] 杨文刚, 赖义明, 黄浩, 黄海. 斜跨位上下联通置入Allium覆膜输尿管支架治疗输尿管狭窄的初步经验[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 340-345.
[6] 方道成, 陈立新, 胡媛媛. 输尿管支架结壳的相关研究进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 402-405.
[7] 马振威, 宋润夫, 王兵. ERCP胆道内支架与骑跨十二指肠乳头支架置入治疗不可切除肝门部胆管癌疗效的Meta分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 807-812.
[8] 韩加刚, 王振军. 梗阻性左半结肠癌的治疗策略[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 450-458.
[9] 石阳, 于剑锋, 曹可, 翟志伟, 叶春祥, 王振军, 韩加刚. 可扩张金属支架置入联合新辅助化疗治疗完全梗阻性左半结肠癌围手术期并发症分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 464-471.
[10] 梁轩豪, 李小荣, 李亮, 林昌伟. 肠梗阻支架置入术联合新辅助化疗治疗结直肠癌急性肠梗阻的疗效及其预后的Meta 分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 472-482.
[11] 张迪, 王春霞, 张学东, 李发馨, 庞淅文, 陈一锋, 张维胜, 王涛. 梗阻性左半结直肠癌自膨式金属支架置入后行腹腔镜手术与开腹手术的短期临床疗效比较[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 375-380.
[12] 胡子豪, 王喆, 陈建海, 齐岩松, 徐永胜. 聚合物材料在肩袖损伤治疗中的研究进展[J/OL]. 中华肩肘外科电子杂志, 2024, 12(04): 362-368.
[13] 孙明策, 韩世焕. 海藻酸盐水凝胶支架在颅骨缺损修复中的应用进展[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 310-314.
[14] 吴荣奎, 吴静, 冯俊浩, 钟嘉懿. 临床护理路径在经股动脉入路介入患者的应用[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 729-733.
[15] 牟磊, 徐东成, 韩鑫, 徐长江, 韩坤锜, 薛叶潇, 牟媛, 秦文玲, 刘相静, 陈哲, 高楠. 五虫通络胶囊防治椎动脉开口支架术后再狭窄发生的效果[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 467-472.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?