Effect analysis of the technique of retrograde puncture of popliteal artery applied in the interventional therapy of lower extremity arteriosclerosis obliterans patients

为探讨腘动脉逆行穿刺在下肢动脉硬化跨大西洋学会间共识（ TASC） C／D级病变治疗中的应用效果，回顾性分析35例下肢动脉硬化患者病例资料，男28例，女7例，平均年龄（72±8）岁；Rutherford分级3级23例，4级8例，5级4例；术前踝肱比（ ABI）平均0．35±0．14；CT血管成像（CTA）病变长度平均（18±5）cm。结果显示，35例技术成功率100％；穿刺时间平均（6±4）min。6例穿刺部位使用了4 F鞘管，29例使用无鞘技术。27例导丝逆向通过股浅动脉闭塞病变进入真腔，8例应用双向内膜下血管成形术（SAFARI）技术后建立导丝轨道。穿刺并发症发生率14．2％（5／35），2例术后次日出现穿刺点血肿，2例假性动脉瘤形成，1例出院前多普勒超声提示腘动脉穿刺区域存在动静脉瘘，均采用保守治疗。提示腘动脉逆行穿刺是一种安全可靠的方法。To investigate the effectiveness of retrograde puncture of popliteal artery in lower extremity arteriosclerosis obliterans ( ASO ) patients classified as TASC ( Tans-Atlantic Inter-Society Consensus) C/D.Retrospective analysis of 35 lower extremity ASO patients, 28 male and 7 female , the mean age was 72 ±8, 23 cases of Rutherford 3, 8 cases of Rutherford 4 and 4 cases of Rutherford 5. Preoperative ABI was 0.35 ±0.14, Lesion length in CT angiography ( CTA ) was ( 18 ±5 ) cm.The technique success rate of 35 cases was 100%.The puncture time was (6 ±4) min.6 cases used 4 F sheath and 29 cases used no sheath technology at the puncture site.In 27 cases guide wires passed retrograde through the occluded superficial femoral artery lesion and returned to the true lumen.8 cases of SAFARI technology to established the guild wire track.The complication rate of retrograde puncture was 14.2%( 5/35), 2 cases of postoperative hematoma appeared at the puncture site the next day, 2 cases of pseudoaneurysms emerged and 1 case of postoperative arteriovenous fistula at the puncture site of popliteal area were found by Doppler ultrasonography before discharged.All 5 patients were recovered by conservative treatment.The retrograde puncture of popliteal artery is a safe and reliable method.中国科技核心期刊(ISTIC)3215-2181