Experience sharing of ultrasound<b>-</b>guided endovascular treatment for femoropopliteal arteriosclerosis obliteran: clinical analysis of 112 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CUI Fengqiang ,  YUAN Shifang , CHEN Jianghao , YAN Changjiao , WANG Hui , SHI Wenlong , ZHANG Dai

Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, P. R. China;

Corresponding?author：

YUAN Shifang, Email: shifangy@fmmu.edu.cn

Keywords：

arteriosclerosis obliteran; ultrasound-guided; endovascular treatment; Rutherford grade; ankle-brachial index

DOI：

10.7507/1007-9424.202305058

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the safety and effectiveness of ultrasound-guided endovascular treatment for femoropopliteal arteriosclerosis obliteran (ASO). Methods The clinical data of patients with femoropopliteal ASO were collected and analyzed. The patients were treated by ultrasound-guided endovascular intervention in the Xijing Hospital of Air Force Military Medical University, from March 2015 to June 2021. The endovascular intervention methods included the arterial balloon dilation (ABD) alone, stent implantation (SI), Rotarex mechanical thrombus removal (Abbreviationas: Rotarex), and thrombolytic catheter implantation (CDT), etc. Results All 112 patients (121 affected extremities) who met the research criteria were collected. Among them, there were 13, 68, and 40 affected extremities by the Rutherford classification of 2, 3, and 4, respectively, while 41, 39, and 41 affected extremities by the Trans-Atlantic Inter-SocietyConsensus Ⅱ classification of A, B, and C, respectively. Among 121 affected extremities, 61 underwent the ABD alone, 27 underwent ABD plus Rotarex, 12 underwent ABD plus SI, 6 underwent ABD plus SI plus Rotarex, 3 underwent ABD plus SI plus CDT, 7 underwent ABD plus CDT plus Rotarex, and 5 underwent ABD plus CDT. The ultrasound-guided endovascular treatments were completed successfully in 118 affected extremities (the success rate was 97.5%), and 3 affected extremities were not completely completed by ultrasound guidance. After operation, 5 affected extremities had pseudoaneurysm and 7 affected extremities had hematoma at the puncture site, which were cured after conservative management. The ankle-brachial index (ABI) of the affected extremities immediately after surgery was statistically higher than that before surgery [0.89±0.13 vs. 0.53±0.09, mean difference (95% confidence interval)=0.36 (0.34, 0.38), paired t-test (t=–25.17), P<0.001]. After a follow-up of 12 months, one patient had a metatarsal amputation and one patient died (acute myocardial infarction). The restenosis rate and reintervention rate of the target lesions were 25.0% (30/120) and 15.0% (18/120) at 12 months postoperatively, and the late loss of diameter was (0.88±0.25) mm. The ABI was still higher than before surgery [0.78±0.13 vs. 0.53±0.09, mean difference (95% confidence interval)=0.25 (0.22, 0.27), paired t-test, t=–17.61, P<0.001]. Conclusion From analysis results of this data, it can be seen that, ultrasound-guided endovascular intervention is a safe and effective treatment for selective femoropopliteal ASO.

Citation： CUI Fengqiang, YUAN Shifang, CHEN Jianghao, YAN Changjiao, WANG Hui, SHI Wenlong, ZHANG Dai. Experience sharing of ultrasound-guided endovascular treatment for femoropopliteal arteriosclerosis obliteran: clinical analysis of 112 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(9): 1093-1097. doi: 10.7507/1007-9424.202305058 Copy

1.	Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS): document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J, 2018, 39(9): 763-816.
2.	張愷欣, 張明, 陳軍, 等. 藥物涂層球囊擴張與經皮腔內球囊擴張合并支架植入術對下肢動脈硬化閉塞病變患者治療的各項臨床指標的影響. 河北醫學, 2022, 28(6): 960-964.
3.	魏立春, 侯培勇, 谷涌泉. 股腘動脈鈣化病變腔內治療技術新進展. 實用醫學雜志, 2021, 37(1): 115-120.
4.	Bausback Y, Willfort-Ehringer A, Sievert H, et al. Six-month results from the initial randomized study of the ranger paclitaxel-coated balloon in the femoropopliteal segment. J Endovasc Ther, 2017, 24(4): 459-467.
5.	Malik A. Prevention of contrast-induced acute kidney injury. Br J Hosp Med (Lond), 2015, 76(12): 685-689.
6.	Deek H, Newton P, Sheerin N, et al. Contrast media induced nephropathy: a literature review of the available evidence and recommendations for practice. Aust Crit Care, 2014, 27(4): 166-171.
7.	Wakabayashi M, Hanada S, Nakano H, et al. Ultrasound-guided endovascular treatment for vascular access malfunction: results in 4 896 cases. J Vasc Access, 2013, 14(3): 225-230.
8.	中國醫院協會血液凈化中心管理分會血液凈化通路學組. 中國血液透析用血管通路專家共識. 中國血液凈化, 2014, 13(8): 549-558.
9.	Ascher E, Marks NA, Hingorani AP, et al. Duplex-guided endovascular treatment for occlusive and stenotic lesions of the femoral-popliteal arterial segment: a comparative study in the first 253 cases. J Vasc Surg, 2006, 44(6): 1230-1237.
10.	戴貽權, 莊勇, 陳宏宇, 等. 彩色多普勒超聲引導下腔內治療股腘動脈硬化閉塞癥. 中國介入影像與治療學, 2016, 13(4): 226-229.
11.	張杰, 趙亮, 周靜, 等. 多普勒超聲引導對股淺動脈閉塞合并腎功能不全患者行腔內介入治療6例臨床分析. 心肺血管病雜志, 2013, 32(3): 343-346.
12.	廖智杰, 郭思恩. 彩色多普勒超聲引導球囊擴張治療下肢動脈硬化性閉塞癥2例報道. 廣西醫科大學學報, 2014, 31(2): 318.
13.	吳中儉, 崔世軍, 郭連瑞, 等. 超聲引導介入治療外周動脈硬化閉塞癥. 中國微創外科雜志, 2022, 22(5): 425-430.
14.	陳忠, 楊耀國. 下肢動脈硬化閉塞癥腔內治療進展. 中國普外基礎與臨床雜志, 2018, 25(1): 3-9.
15.	單海豐, 周密, 康春博. 外周血miRNA-4463表達水平對藥物涂層球囊治療下肢閉塞性動脈硬化后復發的影響因素分析. 血管與腔內血管外科雜志, 2020, 6(6): 487-491.
16.	Tian J, Tang YD, Qiao S, et al. Two-year follow-up of a randomized multicenter study comparing a drug-coated balloon with a drug-eluting stent in native small coronary vessels: The RESTORE Small Vessel Disease China trial. Catheter Cardiovasc Interv, 2020, 95 Suppl 1: 587-597.
17.	安鵬, 尹家保, 楊浩, 等. 床旁彩色多普勒超聲引導腘靜脈置管溶栓療法在下肢深靜脈血栓治療中的應用. 中國介入影像與治療學, 2018, 15(3): 144-147.
18.	Ascher E, Gopal K, Marks N, et al. Duplex-guided endovascular repair of popliteal artery aneurysms (PAAs): a new approach to avert the use of contrast material and radiation exposure. Eur J Vasc Endovasc Surg, 2010, 39(6): 769-773.
19.	Sato DT, Robinson KD, Gregory RT, et al. Duplex directed caval filter insertion in multi-trauma and critically ill patients. Ann Vasc Surg, 1999, 13(4): 365-371.
20.	姚佐懿, 羅菲菲, 周翔宇, 等. 超聲引導下經皮凝血酶注射對醫源性股動脈復雜假性動脈瘤的應用研究. 重慶醫學, 2017, 46(4): 450-452.

1. Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS): document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J, 2018, 39(9): 763-816.
2. 張愷欣, 張明, 陳軍, 等. 藥物涂層球囊擴張與經皮腔內球囊擴張合并支架植入術對下肢動脈硬化閉塞病變患者治療的各項臨床指標的影響. 河北醫學, 2022, 28(6): 960-964.
3. 魏立春, 侯培勇, 谷涌泉. 股腘動脈鈣化病變腔內治療技術新進展. 實用醫學雜志, 2021, 37(1): 115-120.
4. Bausback Y, Willfort-Ehringer A, Sievert H, et al. Six-month results from the initial randomized study of the ranger paclitaxel-coated balloon in the femoropopliteal segment. J Endovasc Ther, 2017, 24(4): 459-467.
5. Malik A. Prevention of contrast-induced acute kidney injury. Br J Hosp Med (Lond), 2015, 76(12): 685-689.
6. Deek H, Newton P, Sheerin N, et al. Contrast media induced nephropathy: a literature review of the available evidence and recommendations for practice. Aust Crit Care, 2014, 27(4): 166-171.
7. Wakabayashi M, Hanada S, Nakano H, et al. Ultrasound-guided endovascular treatment for vascular access malfunction: results in 4 896 cases. J Vasc Access, 2013, 14(3): 225-230.
8. 中國醫院協會血液凈化中心管理分會血液凈化通路學組. 中國血液透析用血管通路專家共識. 中國血液凈化, 2014, 13(8): 549-558.
9. Ascher E, Marks NA, Hingorani AP, et al. Duplex-guided endovascular treatment for occlusive and stenotic lesions of the femoral-popliteal arterial segment: a comparative study in the first 253 cases. J Vasc Surg, 2006, 44(6): 1230-1237.
10. 戴貽權, 莊勇, 陳宏宇, 等. 彩色多普勒超聲引導下腔內治療股腘動脈硬化閉塞癥. 中國介入影像與治療學, 2016, 13(4): 226-229.
11. 張杰, 趙亮, 周靜, 等. 多普勒超聲引導對股淺動脈閉塞合并腎功能不全患者行腔內介入治療6例臨床分析. 心肺血管病雜志, 2013, 32(3): 343-346.
12. 廖智杰, 郭思恩. 彩色多普勒超聲引導球囊擴張治療下肢動脈硬化性閉塞癥2例報道. 廣西醫科大學學報, 2014, 31(2): 318.
13. 吳中儉, 崔世軍, 郭連瑞, 等. 超聲引導介入治療外周動脈硬化閉塞癥. 中國微創外科雜志, 2022, 22(5): 425-430.
14. 陳忠, 楊耀國. 下肢動脈硬化閉塞癥腔內治療進展. 中國普外基礎與臨床雜志, 2018, 25(1): 3-9.
15. 單海豐, 周密, 康春博. 外周血miRNA-4463表達水平對藥物涂層球囊治療下肢閉塞性動脈硬化后復發的影響因素分析. 血管與腔內血管外科雜志, 2020, 6(6): 487-491.
16. Tian J, Tang YD, Qiao S, et al. Two-year follow-up of a randomized multicenter study comparing a drug-coated balloon with a drug-eluting stent in native small coronary vessels: The RESTORE Small Vessel Disease China trial. Catheter Cardiovasc Interv, 2020, 95 Suppl 1: 587-597.
17. 安鵬, 尹家保, 楊浩, 等. 床旁彩色多普勒超聲引導腘靜脈置管溶栓療法在下肢深靜脈血栓治療中的應用. 中國介入影像與治療學, 2018, 15(3): 144-147.
18. Ascher E, Gopal K, Marks N, et al. Duplex-guided endovascular repair of popliteal artery aneurysms (PAAs): a new approach to avert the use of contrast material and radiation exposure. Eur J Vasc Endovasc Surg, 2010, 39(6): 769-773.
19. Sato DT, Robinson KD, Gregory RT, et al. Duplex directed caval filter insertion in multi-trauma and critically ill patients. Ann Vasc Surg, 1999, 13(4): 365-371.
20. 姚佐懿, 羅菲菲, 周翔宇, 等. 超聲引導下經皮凝血酶注射對醫源性股動脈復雜假性動脈瘤的應用研究. 重慶醫學, 2017, 46(4): 450-452.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience sharing of ultrasound-guided endovascular treatment for femoropopliteal arteriosclerosis obliteran: clinical analysis of 112 cases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content