BTK血管闭塞腔内治疗进展.ppt

BTK 血管病变腔内治疗进展 邹英华 北京大学 第一医院 BTK 病变腔内治疗现状 腔内开通闭塞血管病变器材发展迅猛 专用导丝、球囊、专用支架 腔内治疗开通闭塞病变技术逐渐成熟 近期疗效满意？！ 长期疗效？ 近期再闭塞？！ POBA后再狭窄的主要原因 血管弹性回缩：支架 血管负面重塑：支架 内膜增生：药物球囊 支架在BTK闭塞病变的应用效果？ 普通冠状动脉支架没有优势专用支架的研究如何？ 药物洗脱支架与POBA POBA 与 DCB 小 结 BKT 病变，尤其长段病变POBA治疗后再狭窄临床的主要问题 专用支架、药物洗脱支架的应用可降低再狭窄率。但使用位置受限 药物球囊的初步临床研究，结果令人鼓舞 * 根据术前造影显示胫前动脉、胫腓干、腓动脉及胫后动脉均可见残端，均可以尝试开通。而下段经侧枝显影的为胫后动脉和腓动脉可能开通更为容易 Case 1 腓动脉导丝通过并扩张 胫后动脉导丝通过并扩张 PTA后 造影 BTK病变，AT、PT均闭塞。 注意胫前动脉短小盲端 Case 2 导丝试探通过ATA闭塞段成功 分别扩张胫前动脉及腓动脉 正位下足动脉弓呈α形 均为冠脉支架，非专用支架 结 果 161 patients enrolled 79 BMS 82 SES 12 died 3 patients were lost to fu 8 died 4 patients were lost to fu 67 patients at 6 months follow-up 64 patients at 6 months follow-up 3 died 2 died 1 patient telephone contact 2 patients telephone contact 62 patients at 12 months follow-up 63 patients at 12 months follow-up 1 patient was lost to fu Angiologie Herz-Zentrum Bad Krozingen DES-BTK Study P=0.004 (primary patency) P=0.005 (secondary patency) Angiologie Herz-Zentrum Bad Krozingen Summary SES achieve significantly higher primary and secondary patency rates at 1 year as compared with BMS in the treatment of infrapopliteal lesions. The improvement in Rutherford-Becker class at 1 year was significantly better in the SES group. In the long run, the superior patency of SES may also improve limb salvage rates in patients with CLI Rutherford class 5 6 and an appropriate life expectancy. Angiologie Herz-Zentrum Bad Krozingen *