| Objective:To compare the early efficacy of Smartflex stent implantation with drug-coated balloon(DCB)combined with Smart stent implantation in the treatment of long-segment femoropopliteal atherosclerosis obliterans(FPASO),which is suitable for clinical selection The surgical method provides a certain basis.Methods:The patients who were diagnosed with long-segment femoral popliteal arteriosclerosis obliterans and received endovascular treatment from January 1,2017 to December 31,2020 in the Department of Vascular Surgery of Shaoxing People’s Hospital were collected based on clinical manifestations and imaging data.81 patients(84 limbs),of which 54 limbs were treated with Smartflex stent,and 30 limbs were treated with DCB combined with Smart stent,hereinafter referred to as stent group and combined treatment group,and were followed up for 12 months.The general baseline characteristics of the patients(including age,gender,affected side,body mass index,risk factors,lesion extent,lesion length,lumen stenosis and TASC II classification,etc.)were recorded,and the surgical technique success rate and operation time of the two groups were determined.,length of hospital stay,Ankle brachial index(ABI)before surgery and 6 months after surgery,changes in Rutherford staging before surgery,6 months and 12 months after surgery,and 12 months after surgery The first-stage patency rate,the second-stage vascular patency rate,In stent restenosis(ISR),the clinically-driven target lesion revascularization(CD-TLR)rate and postoperative complications,The above indexes were used to compare the early postoperative curative effect by statistical method.Results:All 81 eligible patients(84 limbs)were technically successful.The average age of the patients was 75.47±8.52 years old,57 male patients,24 female patients,62 patients with hypertension,42 patients with diabetes,8 patients with hyperlipidemia,10 patients with coronary artery disease,and 14 patients with cerebral infarction,5 patients with chronic kidney disease,and 41 patients with a history of smoking.The follow-up time was 12 months.In the stent group,51 patients(54 affected limbs)were included.The average lesion length was 15.98±6.43 cm,the preoperative lumen stenosis rate was82.74%±20.83%,and the preoperative and postoperative ABIs were 0.38±0.15 and0.83±0.23,respectively.The first-stage patency rate was 83.33%,the second-stage patency rate was 87.00%,the ISR was 14.81%,the CD-TLR was 12.96%,the operation time was 100.31±30.83 minutes,the hospital stay was 12.09±5.38 days,and the incidence of postoperative complications was was 20.37%.The combined treatment group included 30 patients(30 affected limbs),the average lesion length was 16.27±6.58 cm,the preoperative lumen stenosis rate was84.77%±16.69%,and the preoperative and postoperative ABI were 0.31±0.16 and0.73±0.17,respectively.,the first-stage patency rate was 76.67%,the second-stage patency rate was 86.67%,the ISR was 20.00%,the CD-TLR was 13.33%,the operation time was 120.03±49.98 minutes,the hospital stay was 14.73±4.22 days,and postoperative complications occurred.The rate was 23.33%.There was no statistical difference in the general baseline characteristics of the two groups of patients and affected limbs(P>0.05).Comparing the postoperative efficacy between the two groups,there was no significant difference in Rutherford staging,ISR,CD-TLR and postoperative complication rates at 6 and 12 months after surgery(P>0.05).The operation time and hospitalization days were statistically significant(P<0.05).Conclusion:(1)For the treatment of long-segment femoral-popliteal arteriosclerosis obliterans,the early efficacy of Smartflex stent treatment was not inferior to that of DCB combined with smart stent treatment,and the ABI value improved significantly half a year after surgery.(2)The Smartflex stent in the treatment of long-segment femoral-popliteal arteriosclerosis obliterans has shorter operation time and hospital stay than DCB combined with smart stent. |
PDF Full Text Request