TurboHawk 斑块切除系统联合药物涂层球囊在治疗股腘 动脉硬化闭塞性疾病中的应用
| 作者: |
1卢维龙,
1王兵,
1吴斐,
1孙利坤,
1牛晓阳,
1王梦宇,
1潘锦轩,
1许恒
1 郑州大学第五附属医院 血管外科，河南 郑州 450052 |
| 通讯: |
王兵
Email: hnxgwk@126.com |
| DOI: | 10.3978/.2018.06.006 |
| 基金: | 河南省高等学校重点科研资助项目（16B320023；18B310032） |
摘要
目的：评价应用 TurboHawk 斑块切除系统联合药物涂层球囊（DCB）治疗股腘动脉硬化闭塞性疾病的安全性和有效性。
方法：2016 年 4 月—2017 年 10 月，对 17 例股腘动脉硬化闭塞性疾病患者应用 TurboHawk 斑块切除系统联合 DCB 治疗。17 例患者平均年龄（66.9±10.5）岁；其中男 14 例，女 3 例；股腘动脉狭窄病变 13 例，闭塞性病变 4 例；术前 Rutherford 分级 2~5 级；术前踝肱指数（ABI）为 0.49±0.18。
结果：17 例患者的血管病变全部经腔内开通成功，其中 1 例股动脉穿孔患者行补救性覆膜支架植入术，另 1 例远端栓塞患者经股动脉切开球囊导管取栓后血流恢复通畅，技术成功率 88.2%。术后 ABI为 0.99±0.27，明显高于术前（P=0.03）。术后 3、6 个月一期通畅率分别为 94.1%，88.2%，二期通畅率 100%。
结论：TurboHawk 斑块切除系统联合药物涂层球囊治疗股腘动脉硬化闭塞性疾病安全有效，早期效果满意。
关键词：
动脉闭塞性疾病；股动脉；腘动脉；斑块切除术；球囊取栓术；血管内操作
方法：2016 年 4 月—2017 年 10 月，对 17 例股腘动脉硬化闭塞性疾病患者应用 TurboHawk 斑块切除系统联合 DCB 治疗。17 例患者平均年龄（66.9±10.5）岁；其中男 14 例，女 3 例；股腘动脉狭窄病变 13 例，闭塞性病变 4 例；术前 Rutherford 分级 2~5 级；术前踝肱指数（ABI）为 0.49±0.18。
结果：17 例患者的血管病变全部经腔内开通成功，其中 1 例股动脉穿孔患者行补救性覆膜支架植入术，另 1 例远端栓塞患者经股动脉切开球囊导管取栓后血流恢复通畅，技术成功率 88.2%。术后 ABI为 0.99±0.27，明显高于术前（P=0.03）。术后 3、6 个月一期通畅率分别为 94.1%，88.2%，二期通畅率 100%。
结论：TurboHawk 斑块切除系统联合药物涂层球囊治疗股腘动脉硬化闭塞性疾病安全有效，早期效果满意。
Application of TurboHawk atherectomy device combined with drug-coated balloon in treatment of femoropopliteal occlusive diseases
CorrespondingAuthor:WANG Bing Email: hnxgwk@126.com
Abstract
Objective: To evaluate the safety and effi cacy of using TurboHawk atherectomy device in combination with drug-coated balloon (DCB) in treatment of femoropopliteal occlusive diseases.
Methods: During April 2016 to October 2017, the treatment of using TurboHawk atherectomy device in combination with DCB was performed in 17 patients with femoropopliteal occlusive diseases. Of the 17 patients, the average age was (66.9±10.5) years; 14 cases were male and 3 cases were female; 13 cases had femoropopliteal stenosis and 4 cases had femoropopliteal occlusion; the preoperative Rutherford classifi cation ranged from 2 to 5 and the preoperative ankle brachial index (ABI) was 0.49+0.18. Doppler ultrasound, CTA or MRA was used to evaluate the patency of target-lesion, postoperatively.
Results: Endovascular recanalization of the target lesions were successfully performed in all the 17 patients, of whom, one case with femoral artery perforation underwent salvage covered-stent placement, and one case with distal embolization achieved vascular patency after balloon catheter embolectomy via incision of the femoral artery, and the technical success rate was 88.2%. The postoperative ABI was 0.99±0.27, and it was significantly higher than the preoperative value (P=0.03). The primary patency rate at postoperative 3 and 6 months was 94.1% and 88.2% respectively, and the secondary patency was 100%.
Conclusion: Using TurboHawk atherectomy device in combination with DCB is safe and effective in treatment of femoropopliteal occlusive diseases, with favorable short-term results.
Keywords：
Arterial Occlusive Diseases; Femoral Artery; Popliteal Artery; Atherectomy; Balloon Embolectomy; Endovascular Procedures
Methods: During April 2016 to October 2017, the treatment of using TurboHawk atherectomy device in combination with DCB was performed in 17 patients with femoropopliteal occlusive diseases. Of the 17 patients, the average age was (66.9±10.5) years; 14 cases were male and 3 cases were female; 13 cases had femoropopliteal stenosis and 4 cases had femoropopliteal occlusion; the preoperative Rutherford classifi cation ranged from 2 to 5 and the preoperative ankle brachial index (ABI) was 0.49+0.18. Doppler ultrasound, CTA or MRA was used to evaluate the patency of target-lesion, postoperatively.
Results: Endovascular recanalization of the target lesions were successfully performed in all the 17 patients, of whom, one case with femoral artery perforation underwent salvage covered-stent placement, and one case with distal embolization achieved vascular patency after balloon catheter embolectomy via incision of the femoral artery, and the technical success rate was 88.2%. The postoperative ABI was 0.99±0.27, and it was significantly higher than the preoperative value (P=0.03). The primary patency rate at postoperative 3 and 6 months was 94.1% and 88.2% respectively, and the secondary patency was 100%.
Conclusion: Using TurboHawk atherectomy device in combination with DCB is safe and effective in treatment of femoropopliteal occlusive diseases, with favorable short-term results.