The Application Of Angioplasty Treatment In The Lower Extremity Atherosclerotic Occlusive Disease And The Shotr-term Effect

Objective:To observe the short-term therapy effect and explore the method and techniqueof angioplasty treatment in the lower extremity atherosclerotic occlusive disease.Methods:This study collected the cases of36(42limbs) with lower extremityatherosclerotic occlusive disease and good distal outflow tract,from September2009toDecember2011in the third clinical medical college at Jilin university.22cases were male and14cases were females, aged46~80years old, average (63.5±7.2) years of age. the course from9months to10years, involvement of a single lower limb in30cases, bilateral in6cases.According to Fontaine system for chronic lower limb ischemia in patients with clinicalclassification: Ⅱa period in3cases (7.14%), Ⅱb period in26cases(61.91%),Ⅲ period in12cases (28.57%),Ⅳperiod in1cases (2.38%).In accordance with TransAtlantic Inter-SocietyConsensus Ⅱ staging in2007,Aortoiliac artery lesions: TASC B4, TASC D2; Femoral poplitealartery lesions: TASC A18,TASC B15;Popliteal artery following lesions: TASC A2,TASC B1.Preoperative ankle-brachial index (ABI) value in0-0.67, for an average of0.37±0.18.using“step and step”skill, Subintimal angioplasty, guidewire looping technique,and so on, by whichway Percutaneous transluminal angioplasty(PTA) and (or)PTAS were performed on patientswith lower limb arteriosclerosis Occlusive disease. Image assessment,clinical symptoms,ankle-brachial index were evaluated before and after the treatment.statistical software packageswas used in data collation of the ABI.p＜0.05These were significant difference; Observation ofcurative effect in the near future and explore the successful opening operation methods andtechniques.Results:In the36patients(42limbs) underwent angioplasty treatment,technical success ratewas100%(42/42). There were6iliac artery pathological changes,stent was eight. There were6cases in iliac artery pathological changes,stent was eight.33Superficial femoral artery,total22pieces of stent. Popliteal artery following lesions of3cases, Both the application of Deepballoon opened successfully, not the implantation of stents, to maintain a good flow rate, thedistal blood supply increased significantly.Postoperative angiography and discharged beforeroutine color Doppler ultrasonography and anatomic improvement100%. ankle-brachial indexof preoperative is0.37±0.18and postoperative is0.82±0.12, with statistical significance. Clinical symptoms gained improvement with different degree. According to Marinelli DLproposed evaluation standard, which was improved in19, moderate improvement in22, mildimprovement in1. Recently there is no further deterioration. Fontaine stage were alsosignificantly improved, Ⅰ period in5cases(11.90%), Ⅱa period in28cases(66.67%), Ⅱbperiod in6cases(14.29%), Ⅲ period in3cases (7.14%).Patients were followed up from6-24,An average of12months.The6-month，12-month，24months primary patency of the iliacartery lesions in6patients was100%、100%、83.3%。The3-month,6-month，12-month，24months the primary patency of the superficial femoral artery lesions in33patients was82.3%、70.4%、52.6%and42.4%. Popliteal artery following lesions in3patients,3months100%patency rate.Conclusions:(1) According to the position, type and length of chronic lower extremityatherosclerotic occlusive disease, using different technology contribute to improve the successrate of operation,it can gain a better short-term effect.(2) Angioplasty treatment is effective,safe,minimally invasive for treating lower extremity atherosclerotic occlusive disease,and can gain asatisfactory short-term effect.(3) As a result of this study the sample number is little, technicalsuccess rate is higher, obtaining a satisfactory short-term effect,as to the long term,we need dosome further study.