| Objective To research the medium and short-term patency rate and clinical curative effect in the treatment of femoropopliteal artery occlusion disease(FAD) through implanting Viabahn covered stents and bare stents by endovascular treatment based on the analysis of the clinical data of 95 cases of FAD patients and analyze the related risk factors, and to provide certain theory basis for the clinical choice of FAD stenting.Methods The clinical data of 95 patients with FAD including patient age, gender, medical history, basic diseases, invasive surgery and the types of stent and related information were collected. All the selected patients were treated in Vascular Surgery of the Fifth Affiliated Hospital of Zhengzhou University from January 2013 to January 2015 and their TASCⅡwas B, C, D. All of the patients were provided conventional color doppler ultrasound and CT angiography(CTA) imaging examinations after admission. They were divided into two groups, Viabahn stent group and bare-metal group, depending on the type of stent placement. There were 44 patients in the Viabahn stent group with 44 Viabahn stents and 51 patients in the bare-metal group with 51 bare stents. The retrospective analysis was used in this paper and all the patients were given regular follow-ups in clinic. The blood flow in stents and clinical therapeutic effect were observed by artery ultrasonography and CTA. The data were analyzed using the SPSS17.0. The primary patency rate, second patency rate, cumulative limb salvage rate and the rate of stent fracture were analyzed in the twp groups. Meanwhile the related risk factors affecting the primary patency rate were analyzed.Results 1. This study collected 95 cases of patients with body,(55 male and female 40 cases, mean age(67.32±3.24) years, clinical symptoms improved significantly in the two groups of patients, all patients with surgical technical success rate was 100%.Viabahn covered stents and bare stents group of perioperative incidence of main complications were 9.1% and 9.1% respectively, there was no statistically significant difference(P>0.05).Viabahn covered stent group ABI from 0.23±0.15 preoperatively to(0.89±0.27) postoperative;Bare stents groups ABI from 0.20±0.21 preoperatively to 0.92±0.18, differences were statistically significant(P<0.05). 2.The overall follow-up rate of 88.4%, a total of 11 patients were lost to follow-up, 3 to 24 months follow-up time.All patients with a total of 7 cases of amputation, always the amputation rate was 7.4%, no deaths in the process of follow-up.Viabahn covered stent group 3, 6, 12, 24 months after the first phase of patency rate was 97.7%, 90.9%, 63.6%, 90.9%, the second phase of patency rate was 100%, 97.7%, 86.4%, 97.7%, stent group 3, 6, 12, 24 months after the first phase of patency rate was 92.3%, 82.4%, 56.9%, 82.4%, the second phase of the stent patency rate was 98.0%, 94.1%, 84.3%, 78.4%, by statistical analysis showed that two groups of intentionality bracket issue patency rate and phase ii patency rate differences are not significant(P>0.05). 3. Viabahn covered stent group accumulated limb salvage rate was 95.5%, the bare stent group accumulated limb salvage rate was 96.1%, the rate of two groups of cumulative limb-salvage no statistically significant difference(P>0.05).Viabahn covered stents groups fracture rate was 2.3%, the fracture rate was 25.5%, the bare stents groups stent fracture rate is similar between the two groups was statistically significant(P<0.05).By Cox regression analysis found that TASC Ⅱ grading, outflow spatially-integrated SVS score, Rutherford classification was the main risk factors of affect the issue of patency rate.Conclusions 1. The Viabahn covered stents and bare stents have similar clinical curative effect in the treatment of FAD. There is not obvious difference in terms of medium and short-term patency rate between them. 2. The rate of stent fracture of Viabahn covered stents is significantly lower than that of bare nitinol stents during the follow-up period. The flexibility of Viabahn coated stents is better. 3. TASC Ⅱ classification and grade of Rutherford, knee spatially-integrated SVS outflow the score are the major risk factors of affecting the primary patency rate. |
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