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首页> 外文期刊>Vascular and endovascular surgery >Limb salvage angioplasty in poor surgical candidates.
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Limb salvage angioplasty in poor surgical candidates.

机译：不良手术候选人的肢体抢救血管成形术。

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This study was conducted to evaluate the potential for percutaneous catheter based limb salvage angioplasty in patients who have no surgical bypass option. Twenty patients, 12 males and 8 females, with end-stage limb ischemia (Rutherford category 4 and 5) were treated with balloon angioplasty. Antegrade femoral access, coronary guidewire, and balloons were used. The aim of intervention was to prevent major amputation with low morbidity and mortality. Technical success was based on intent to treat and radiologic patency after the procedure. Clinical success was based on healing of ischemic ulcers, resolution of rest pain, improvement of ankle-brachial index (ABI) >0.10, or healing of a minor amputation site. Limb salvage is defined as preservation of functional foot without a need for prosthesis for ambulation. The mean age of the patients was 67.5 years. Mean follow-up was 8.8 months. Indications for revascularization were rest pain (2). ischemic ulcers (9). and gangrene (9). The indications for percutaneous revascularization were lack of a distal surgical target vessel in 10 (2 did not have adequate vein), poor surgical risk in 7 (1 without adequate vein), and short segment lesions in 3. Technical success was achieved in 18 (90%). One of the technical failures required a below-the-knee amputation (BKA). Clinical success was achieved in 15 patients (75%). There was 1 death due to myocardial infarction, and 4 BKAs within 6 weeks of angioplasty. Two patients had recurrent lesions within 6 months. Infra-inguinal arterial angioplasty can achieve limb salvage in patients who are at high surgical risk, or do not have good target vessels or adequate conduits for distal revascularization.
机译：这项研究旨在评估无手术旁路选择的患者中基于经皮导管的肢体抢救血管成形术的潜力。使用球囊血管成形术治疗20例晚期肢体缺血（卢瑟福第4和第5类）的男性12例，女性8例。使用整体股动脉入路，冠状动脉导丝和球囊。干预的目的是防止低发病率和低死亡率的大截肢。技术上的成功是基于手术后的治疗意图和放射通畅性。临床上的成功是基于缺血性溃疡的愈合，静息疼痛的缓解，踝臂指数（ABI）> 0.10的改善或较小的截肢部位的愈合。肢体抢救的定义是保留功能性足，而无需假肢进行活动。患者的平均年龄为67.5岁。平均随访8.8个月。血运重建的指征是休息疼痛（2）。缺血性溃疡（9）。和坏疽（9）。经皮血运重建的指征是：缺少远端外科手术靶血管的有10例（2例没有足够的静脉），缺乏手术风险的有7例（1例没有足够的静脉），有3例为短段病变，在18例中取得了技术成功（ 90％）。其中一种技术故障需要膝下截肢术（BKA）。 15名患者（75％）取得了临床成功。在血管成形术的6周内，有1例因心肌梗塞死亡，4例BKA。 2例患者在6个月内复发。在有高手术风险或没有良好靶血管或远端血管再通的合适导管的患者中，鞘膜下动脉血管成形术可实现肢体抢救。

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