LIGuo-jian , YANGYong , YANGGuo-kai , WANJia , MAZhen-huan , LUPing , DULing-juan
  • Department of Vascular Surgery, The Secondary People's Hospital of Yunnan Province, The Fourth Affiliated Hospital of Kunming Medical University, Kunming 650021, Yunnan Province, China;
YANGYong, Email: yncvs126@126.com
Lower extremity atherosclerotic occlusive disease; Catheter-directed thrombolysis; Minimally invasive techniques of endovascular; Efficacy
10.7507/1007-9424.20150279
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Objective To investigate the therapeutic evaluation of catheter-directed thrombolysis combined with multiple minimally invasive techniques of endovascular in the treatment of lower extremity atherosclerotic occlusive disease (ASO). Methods Clinical data of 64 ASO patients who were treated in our hospital from June 2011 to October 2014 were analyzed retrospectively. These patients were divided into two groups according to the therapies:33 patients were treated by catheter-directed thrombolysis combined with multiple minimally invasive techniques of endovascular (combination group), and the other 31 patients were only treated by multiple minimally invasive techniques of endovascular (intervention group). Comparison of the clinical indexes was performed between the 2 groups, including vascular patency rate, stent implantation rate, operation time, ankle-brachial index (ABI), saturation of blood oxygen (SO2) of toes, temperature of foot skin, amputation rate, and hospitalization expense. Results In the same group (combination group and intervention group), compared with the time point of before operation, the clinical indexes of the ABI, SO2 of toes, and temperature of foot skin were higher after operation (P<0.05). At the same time point of before or after operation, there were no significant difference between the 2 groups in ABI, SO2 of toes, and temperature of foot skin (P>0.05). The vascular patency rate of combination group was higher than that of intervention group[97.0% (32/33) vs. 83.9% (26/31)], P<0.05. But the stent implantation rate[18.2% (6/33) vs. 64.5% (20/31)], amputation rate[3.0% (1/33) vs. 16.1% (5/31)], operative time[(2.0±0.5) h vs. (4.0±1.1) h], and hospitalization expense of patients who got successful limb salvage[(8 500±1 200) yuan vs. (34 000±2 100) yuan] of combination group were all lower or shorter than those of intervention group (P<0.05). After operation, there were no complication happened in the patients who got successful limb salvage of combination group (n=32) and intervention group (n=26). In postoperative 6 months, the lower extremity arteries in patients who got successful limb salvage of combination group and intervention group were all examined by color ultrasonography, and they were unblocked. The lower extremity arteries of the patients with stent implantation in the 2 groups suffered with no obvious stenosis or occlusion. Conclusions Catheter-directed thrombolysis combined with multiple minimally invasive techniques of endovascular can become one of the surgical treatment methods for ASO, which characterized by minimally invasive operation, effective treatment, and low cost.

Citation： LIGuo-jian, YANGYong, YANGGuo-kai, WANJia, MAZhen-huan, LUPing, DULing-juan. Therapeutic Evaluation of Catheter-Directed Thrombolysis Combined with Multiple Minimally Invasive Techniques of Endovascular in The Treatment of Lower Extremity Atherosclerotic Occlusive Disease. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1068-1072. doi: 10.7507/1007-9424.20150279 Copy

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