张杰,
纪东华^,
大连医科大学附属第一医院 介入治疗科，辽宁 大连 116011

详细信息 作者简介: 张 杰（1998-），男，硕士研究生。E-mail：1253718300@qq.com


通讯作者: 纪东华，主任医师。E-mail：nickji@126.com 中图分类号: R654.4


摘要:膝下动脉闭塞性疾病的治疗目前仍以腔内治疗（即动脉成形术）为主。但是相对于其他部位的动脉成形术而言，膝下动脉成形术的通畅率不甚理想。影响膝下动脉成形术通畅率的因素主要包括扩张后夹层、弹性回缩、残余狭窄及再狭窄等。术后内膜增生引发的再狭窄是关键问题。载药器械可以最大程度地降低内膜增生，进而提高通畅率。在降低夹层及弹性回缩的发生方面，各类腔内减容装置的应用已经获得了一定的临床疗效，但仍避免不了进行局部的支架置入，药物洗脱支架及点状支架均有循证医学的证据支持。本文就提高膝下动脉成形术后通畅率的相关临床研究进展作一综述。
关键词: 外周动脉疾病/
经皮腔内血管成形术/
通畅率/
药物洗脱支架/
药物涂层球囊


Abstract:The treatment of occlusive disease of infrapopliteal arteries is still based on endovascular treatment (percutaneous transluminal angioplasty). However, the patency rate of below-the-knee revascularization is not ideal compared with that of angioplasty at other sites. The main factors affecting the patency rate of infrapopliteal angioplasty are: post-dilation dissection, recoil, residual stenosis and restenosis. Restenosis caused by neointimal hyperplasia is the major problem. Drug loading devices can minimize neointimal hyperplasia and thereby improve patency rate. In order to reduce the occurrence of post-dilation dissection and recoil, the application of various percutaneous endovascular atherectomy devices has also obtained certain clinical efficacy. For post-dilation dissection and recoil, stent is still unavoidable. Drug-eluting stents and Tack have been supported by evidence-based medicine. This review summarizes the clinical research progress on improving the patency rate after infrapopliteal angioplasty.
Keywords:peripheral artery disease/
percutaneous transluminal angioplasty/
primary patency rate/
drug-eluting stent/
drug-coated balloon

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https://journal.dmu.edu.cn/data/article/export-pdf?id=65645f7dfa89b26c22aba8e0