Abstract:

Objective　To explore the clinical effect of drug coated balloon dilation and angioplasty for patients with in-stent restenosis of the femoral popliteal artery. Methods　A total of 96 patients with in-stent restenosis of the femoral popliteal artery, who were planned to undergo surgical treatment in Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University from June 2019 to December 2022, were selected as the research subjects. They were divided into a study group and a control group with 48 cases in each group using the random number table method. In the study group, there were 28 males and 20 females, aged (64.1±6.7) years, and the length of lesion was (14.3±4.1) cm. In the control group, there were 33 males and 15 females, aged (62.5±7.2) years, and the length of lesion was (13.8±3.3) cm. The study group was treated with drug coated balloon dilation and angioplasty, while the control group was treated with conventional balloon technique. The changes in ankle-brachial index (ABI), minimum target vessel lumen diameter (MLD), long-term lumen loss (LLL), primary patency rate, Rutherford grade, intermittent claudication distance, and coagulation function were compared between the two groups before and after treatment. Statistical methods used were repeated measure ANOVA, independent sample t test, χ² test, and rank sum test. Results　The ABI values of the two groups 3 months, 6 months, and 12 months after surgery were higher than those before surgery; the ABI value of the study group 12 months after surgery was higher than that of the control group [(0.86±0.11) vs. (0.75±0.14)], with a statistically significant difference (t=4.28, P<0.05). The MLD value of the study group was higher than that of the control group 12 months after surgery [(2.85±0.46) mm vs. (2.53±0.51) mm], with a statistically significant difference (t=3.23, P<0.05). The LLL values of the study group 6 months and 12 months after surgery were lower than those of the control group [(4.56±1.80)% vs. (5.71±1.92)%, (13.37±2.60)% vs. (19.68±3.81)%], with statistically significant differences (t=-3.03 and -9.48, both P<0.05). The Rutherford grade of the study group was lower than that of the control group 12 months after surgery, with a statistically significant difference (Z=-2.19, P<0.05). Three months after surgery, the prothrombin time (PT) and thrombin time (TT) of the study group were higher than those of the control group [(13.41±0.31) s vs. (13.23±0.34) s, (16.92±0.88) s vs. (16.46±0.95) s], with statistically significant differences (t=2.71 and 2.46, both P<0.05). Conclusion　The treatment of in-stent restenosis of the femoral popliteal artery using drug coated balloon dilation and angioplasty is more beneficial than conventional stents in maintaining continuous vascular patency, alleviating the patients' blood hypercoagulable state, and better improving the treatment effect.

Key words:

Femoral artery, Popliteal artery, Stent, Restenosis, Drug coated balloon dilation and angioplasty

摘要：

目的　探讨对股腘动脉支架内再狭窄患者实施药物涂层球囊扩张成形术治疗的临床效果。方法　选取2019年6月至2022年12月西安交通大学第一附属医院血管外科拟实施手术治疗的96例股腘动脉支架内再狭窄患者作为研究对象，采用随机数字表法将其分为研究组和对照组，各48例。研究组男28例、女20例，年龄（64.1±6.7）岁，病变长度（14.3±4.1）cm，采用药物涂层球囊扩张成形术方案治疗；对照组男33例、女15例，年龄（62.5±7.2）岁，病变长度（13.8±3.3）cm，采用常规普通球囊技术治疗。对比两组患者治疗前后踝-肱指数（ABI）、靶血管腔最小直径（MLD）、远期管腔丢失（LLL）、一期通畅率、Rutherford分级、间歇性跛行距离、凝血功能变化。采用重复测量方差分析、独立样本t检验、χ²检验、秩和检验。结果　两组患者在术后3个月、术后6个月、术后12个月的ABI测定值均高于手术前，研究组术后12个月ABI高于对照组［（0.86±0.11）比（0.75±0.14）］，差异有统计学意义（t=4.28，P<0.05）。研究组术后12个月的MLD大于对照组［（2.85±0.46）mm比（2.53±0.51）mm］，差异有统计学意义（t=3.23，P<0.05）。研究组患者术后6个月、术后12个月的LLL值均低于对照组［（4.56±1.80）%比（5.71±1.92）%、（13.37±2.60）%比（19.68±3.81）%］，差异均有统计学意义（t=-3.03、-9.48，均P<0.05）。术后12个月研究组Rutherford分级低于对照组，差异有统计学意义（Z=-2.19，P<0.05）。术后3个月，研究组患者的凝血酶原时间（PT）、凝血酶时间（TT）均较对照组延长［（13.41±0.31）s比（13.23±0.34）s、（16.92±0.88）s比（16.46±0.95）s］，差异均有统计学意义（t=2.71、2.46，均P<0.05）。结论　股腘动脉支架内再狭窄患者采用药物涂层球囊扩张成形术方案治疗较常规支架手术方案具有更好的治疗效果，有利于维持血管持续畅通，缓解患者的血液高凝状态。

关键词:

股动脉, 腘动脉, 支架, 再狭窄, 药物涂层球囊扩张成形术