Effectiveness Analysis In Endovascular Treatment Of Lower Extremity Arteries With Complex Arteriosclerosis Obliterans

Background:Arteriosclerosis obliterans of lower extremity is one of the important part of the systemic atherosclerosis. It is more likely to involve in iliac-femoral artery and femoral-popliteal artery, and distal arteries of the popliteal artery can also be involved in a later term, which makes the type and grade of lesion become more complicated. According to the TASC Ⅱ grade, it tends to be treated by open operation treatment traditionally that the occlusive complex chronic disease involve in popliteal artery and distal arteries, but endovascular therapy has been included in scope of the current clinical practice. And the application of endovascular therapy in complex arteriosclerosis obliterans of femoral-popliteal arteries is not perfect yet.Objective:To investigate the operation indications of endovascular treatment in complex arteriosclerosis obliterans of femoral-popliteal arteries, and analyze the short-medium term therapeutic effectiveness.Methods:From January 2011 to October 2014,42 patients with complex arteriosclerosis obliterans of femoral-popliteal arteries were treated by percutaneous transluminal angioplasty. Various risk factors were analyzed for all the patients, whose pretreatment imaging manifestations were in the range of TASCⅡ C or D grade (femoral-popliteal typing), and clinical manifestations were in the range of Fontaine Ⅱ stage(heavily), Ⅲ and Ⅳ stage. Post-treatment surgical success rate, complication rate were observed. Statistical analysis was used to contrast ankle-brachial index (ABI) pretreatment and post-treatment changes by t test. All the patients were followed up to 3 to 18 months by telephone or outpatient service, and clinical symptoms were analyzed to observe the limb patency rate.Results:A successful recanalization of the arteries in affected limb was achieved in 39 patients by percutaneous transluminal angioplasty. Surgical success rate was 92.8%. Complication incidence in the hospitalization period was 19%. There was a significant difference with the ABI of patients after one week treatment. A followed-up for 3 to 18 months in 42 patients showed a postoperative limb patency rate of 88%.Conclusion:1. It can be used as an effective application that the endovascular surery treats complex arteriosclerosis obliterans of femoral-popliteal arteries when the indication is mastered. Also the endovascular surgery can be provided as a safe and effective treatment, for patients with complex arteriosclerosis obliterans of lower extremity arteries who fit or do not fit the open operation treatment traditionally.2. TASC II classification standard have made a detailed description of the diagnosis of arteriosclerosis obliterans of lower extremity. There are significant improvements still to be made in the classification of complicated chronic femoral-popliteal artery occlusive disease, however. Meanwhile, in order to master the indication of the endovascular treatment, imaging manifestations and clinical manifestations should be considered simultaneously.3. Endovascular surgery has a high success rate of treatment, fewer complications, and a good degree satisfaction of short-medium term linb patency rate. A long-term treatment effectiveness of such complex lesions remains to be seen.