目的：探讨Viabahn 覆膜支架治疗下肢动脉硬化闭塞症的中短期疗效。方法：回顾性分析2013 年1 月—2014 年1 月采用腔内治疗的73 例（73 条肢体）下肢动脉硬化闭塞症患者临床资料，其中32 例行Viabahn 覆膜支架治疗（Viabahn 支架组），41 例行裸支架治疗（裸支架组），比较两组的中短期临床效果。结果： 与裸支架组比较，Viabahn 支架组术后3、6 个月的一期通畅率差异无统计学意义（96.8%vs. 90.2%；87.5% vs. 75.6%， 均P>0.05）， 但术后9、12 个月的一期通畅率明显升高（84.4% vs.63.4%；75.0% vs. 51.2%，均P<0.05）；Log-rank 检验显示Viabahn 支架组12 个月的一期通畅率高于裸支架（P<0.05）。两组术后12 个月踝肱指数（ABI）差异无统计学意义（P>0.05）。结论：下肢动脉硬化闭塞症患者接受血管腔内成形术后，采用Viabahn 覆膜支架疗中短期效果显著，可为近关节下肢动脉硬化闭塞症，尤其是跨膝关节病变的治疗提供了选择。
Efficacy analysis of Viabahn covered stent for arteriosclerosis obliterans of the lower limbs
Objective: To investigate the short and medium term efficacy of Viabahn covered stent in treatment of arteriosclerosis obliterans of the lower limbs. Methods: The clinical data of 73 patients (73 affected limbs) with arteriosclerosis obliterans of the lower limb undergoing endovascular treatment from January 2013 to January 2014 were retrospectively analyzed. Of the patients, 32 cases underwent endovascular Viabahn covered stent placement (Viabahn stent group), and 41 cases received bare-metal stent placement (bare-metal group). The clinical outcomes between the two groups of patients were compared. Results: In Viabahn stent group compared with bare-metal stent group, the primary patency rate at postoperative 3 and 6 months showed no significant difference (96.8% vs. 90.2%; 87.5% vs. 75.6%, both P>0.05), but it was significantly increased at postoperative 9 and 12 months (84.4% vs. 63.4%; 75.0% vs. 51.2%, both P<0.05). Log-rank test result showed that the 12-month patency rate in Viabahn stent group was significantly higher than that in bare stent group (P<0.05). The ankle brachial index (ABI) at postoperative 12 months between the two groups had no significant difference (P>0.05). Conclusion: Viabahn covered stent placement following endovascular angioplasty has significant short and medium term efficacy in treatment of arteriosclerosis obliterans of the lower limbs, and it may be a therapeutic option for arteriosclerosis obliterans of the lower limbs with lesions close to, and especially those crossing over the knee joint.