Abstract:
0bjective To evaluate the effect and influencing factors after undergoing complex operation through balloon angioplasty, endovascular stent implantation(stenting) combined with endarterectomy and throm bectomy in lower extremity arterial occlusive disease.
Methods From January 2005 to November 2009, 318 patients′ clinical data were retrospectively studied after the patients undergoing the double femoral artery centesis balloon angioplasty and endovascular stent implantation(stenting) or endarterectomy and endovascular repair or thrombectomy and endovascular repair to cure lower extremity arterial occlusive disease, including 198 with DLASO(61 with bilateral lesions) 259 side extremity, 120 with LEAOD (41 with bilateral lesions) 161 side extremity. Follow-up was 6 to 36 months, the correlation factors and patency rate of popliteal artery following vascular (primary vascular) and superficial femoral artery (secondary vascular)were analyzed.
Results A total of 318 patients in the initial success rate was DLASO 90% with primary vascular, 92%with secondary vascular; LEAOD 91% with primary vascular, 94% with secondary vascular respectively. Mean follow-up 6 to 36 months, the primary patency in patients with DLASO was significantly lower than patiences with LEAOD. The accumulated (total) secondary patency for primary vascular was 89%-67%, for secondary vascular was 93%-73% respectively. The restenosis rates in the two groups with stenting was significantly lower then those with non-stenting, P<0.05. Multivariate logistic regression analysis on univariate analysis showed that reduced patency rates in DLASO were related to tobacco use(any) history, hypertension and many other factors. No patients with perioperative death and serious complications.
Conclusions There are satisfactory results about the use of complex operation for lower extremity arterial occlusive disease.The clinical effect will be improved, if the influencing factors under control effectively.
Key words:
Diabetes,
Arterial obliterans,
Endovascular repair(EVR),
Stent
Chang-qing GE, Bing HAN, Hong-guang ZHANG, Min ZHANG, Chen-guang ZHOU, Guo-hui JI, Zheng YANG, Liang ZHANG. Study of the effect and influencing factors of complex operation for intractable lower extremity arterial occlusive disease[J]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(04): 345-349.