2020 年第 12 期 第 15 卷

定向斑块旋切联合药物涂层球囊扩张治疗重度钙化股腘动脉硬化闭塞性疾病的安全性和有效性分析

Analysis of the safety and efficacy of directional atherectomy combined with drug coated balloon dilatation in the treatment of severe calcified femoral and popliteal artery occlusive disease

作者：徐创 郑焕勤 陈忠 王盛 唐小斌 杨耀国 杨燎 刘硕

英文作者：Xu Chuang Zheng Huanqin Chen Zhong Wang Sheng Tang Xiaobin Yang Yaoguo Yang Liao Liu Shuo

单位：首都医科大学附属北京安贞医院血管科100029

英文单位：Department of Vascular Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：下肢动脉硬化闭塞症；重度钙化；股动脉；腘动脉；定向斑块旋切联合药物涂层球囊扩张

英文关键词：Arteriosclerosisobliteransinlowerextremity;Severecalcification;Femoralartery;Poplitealartery;Directionalatherectomycombinedwithdrugcoatedballoondilatation

• 摘要：

• 目的 评价定向斑块旋切联合药物涂层球囊扩张（DAART）治疗重度钙化股腘动脉硬化闭塞性疾病的安全性和有效性。方法研究对象为首都医科大学附属北京安贞医院2017年1月至2018年10月行DAART 治疗的47例重度钙化股腘动脉硬化闭塞性疾病患者（包括41例闭塞性病变患者，6例狭窄病变患者），收集患者基本信息、手术技术成功率、手术前后踝肱指数、住院期间影像资料和术后随访信息进行回顾性分析。结果 手术全部顺利完成。46例患者的血管病变经腔内开通成功，技术成功率97.9%。术后6、12个月一期通畅率分别为 95.7%（45/47）、83.0%（39/47），二期通畅率为100%（47/47），患者术后临床症状及卢瑟福分级改善明显。术后12个月复查踝肱指数明显高于术前［（0.89±0.13）比（0.42±0.17）］，差异有统计学意义（P<0.05）。结论 DAART治疗重度钙化的股腘动脉硬化闭塞性疾病安全且有效，术后短期随访患者缺血症状改善明显、效果满意。

• Objective To evaluate the safety and efficacy of directional atherectomy combined with drug coated balloon dilatation (DAART) in treatment of severe calcified femoral popliteal arteriosclerosis occlusive disease. Methods From January 2017 to October 2018, 47 patients with severe calcified femoral and popliteal arteriosclerosis occlusive disease (including 41 patients with occlusive disease and 6 patients with stenosis) treated with DAART admitted to  Beijing Anzhen Hospital， Capital Medical University were selected. The general data, technological success rate of operation, ankle brachial index, imaging data during hospitalization and follow-up data were collected and  analyzed retrospectively. Results All the operations were completed successfully. The vascular lesions of 46 patients were successfully opened through the lumen, with a technical success rate of 97.9%. The primary patency rate at 6 and 12 months after operation was 95.7%（45/47） and 83.0%（39/47）， respectively, and the secondary patency rate was 100%(47/47). The clinical symptoms and Rutherford grade of patients were significantly improved. After 12 months of operation, ankle brachial index was significantly higher than that before operation［(0.89±0.13) vs (0.42±0.17)］ (P<0.05). Conclusion sIt is safe and effective to treat severe calcified femoral popliteal arteriosclerosis occlusive disease by DAART. The short-term follow-up of the patients with ischemic symptoms is obviously improved and the effect is satisfactory.