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BTK 血管病变腔内治疗进展

BTK 血管病变腔内治疗进展. 邹英华 北京大学 第一医院. Case 1. 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. 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. Case 2. BTK 病变， AT 、 PT 均闭塞。 注意胫前动脉短小盲端. 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. 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

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BTK 血管病变腔内治疗进展

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  1. BTK 血管病变腔内治疗进展 邹英华 北京大学 第一医院

  2. Case 1 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

  3. 腓动脉导丝通过并扩张

  4. 胫后动脉导丝通过并扩张

  5. PTA后 造影

  6. Case 2 BTK病变，AT、PT均闭塞。 注意胫前动脉短小盲端

  7. 导丝试探通过ATA闭塞段成功

  8. 分别扩张胫前动脉及腓动脉

  9. 正位下足动脉弓呈α形

  10. 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？！

  11. 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

  12. 支架在BTK闭塞病变的应用效果？

  13. 均为冠脉支架，非专用支架

  14. 结 果

  15. 普通冠状动脉支架没有优势专用支架的研究如何？普通冠状动脉支架没有优势专用支架的研究如何？

  16. 药物洗脱支架与POBA

  17. Angiologie Herz-Zentrum Bad Krozingen DES-BTK Study 161 patientsenrolled 82 SES 79 BMS 12 died 8 died 4 patientswere lost tofu 3 patientswere lost tofu 2 patientstelephonecontact 1 patienttelephonecontact 64 patientsat 6 monthsfollow-up 67 patientsat 6 monthsfollow-up 2 died 3 died 1 patient was lost tofu 62 patientsat 12 monthsfollow-up 63 patientsat 12 monthsfollow-up

  18. Angiologie Herz-Zentrum Bad Krozingen P=0.004 (primary patency) P=0.005 (secondary patency)

  19. Summary Angiologie Herz-Zentrum Bad Krozingen 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.

  20. POBA 与 DCB

  21. 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

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