Preliminary Observation Of Effectiveness Of Stent Extraction In Vascular Reocclusion After Stent Implantation In Arteriosclerosis Obliterans

【Objective】1. Retrospective analysis of clinical effectiveness of endovascular treatment for arteriosclerosis obliterans and the reobstruction after stent implantation.2. Preliminarily observe the clinical effectiveness of stent taking in vascular restenosis after stent implantation in arteriosclerosis obliterans.【Methods】1. The clinical data of117cases who received endovascular treament from October2009to June2013in our Vascular Surgery were reviewed retrospectively.Collecting the data from imaging、medical records、surgerical records and follow-up record to summary characteristics of lesions，clinical symptoms between preoperation and postoperation，changes of ABI，pain scores and health index，and to observe the reobstruction time and reobstruction rate.2.30cases with reobstruction who has taken the surgery of stent implantation are selected. These cases are randomly divided into group A：stent extraction group with10cases (10limbs), group B：cavity treatment group with10cases(10limbs) and group C：conservative treatment group with10cases(10limbs).Group A underwent occlusive segment stent removing and angioplasty under general anesthesia.Group B underwent endovascular treatment with balloon PTA and (or) stent implantation in occlusive segment under local anesthesia, these two groups were combined with antiplatelet, lipid-lowering, and improving circulation postoperatively.And group C only treat with antiplatelet, lipid-lowering, and improving circulation.Analize changes in clinical effectiveness、ankle brachial index(ABI)、pain scores、health index and the situation of vascular patency.【Results】1. In117cases（135limps），clinical symptoms were obviously improved according to curative effect evaluation criteria，with the total effective rate81.6%.ABI rases from （0.42± 0.16） preoperation to （0.75±0.13） postoperation (P<0.05)，the difference was statistically significant.Severe complications occurrence rate is2.6%perioperative period.116limbs were followed up6months to3years after endovascular treatment，and the eobstruction rate was30.2%（35/116).Reobstruction locations are different.Reobstruction occurred from1.5to18months post endovascular procedures.2. Stent extraction group and cavity treatment group are better than conservative treatment group in the clinical effectiveness, ABI, pain score, health index, the patency rate.But there is no significant difference between the former two groups in these respects（P>0.05）.【Conclusions】1. Endovascular treatment for arteriosclerosis obliterans is safe and effective, but there is still a certain degree of occlusion.2. Stent extraction and cavity treatment are more effectively than conservative treatment,and has a satisfactory short-term effect.3. Stent extraction and cavity treatment can reach a same result in vascular restenosis in lower extremity arterial occlusive.It can be used as a new choice for in stent restenosis.