Fate of Collateral Vessels following Subintimal Angioplasty
Fate of Collateral Vessels following Subintimal Angioplasty
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DOI：
10.1583/03-1149.1
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发表时间：
2004-06
期刊：
影响因子：
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通讯作者：
E. Lipsitz;T. Ohki;F. Veith;S. Rhee;H. Kurvers;C. Timaran;N. Gargiulo;W. Suggs;R. Wain
中科院分区：
文献类型：
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作者：
E. Lipsitz;T. Ohki;F. Veith;S. Rhee;H. Kurvers;C. Timaran;N. Gargiulo;W. Suggs;R. Wain
目的：评价内膜下血管成形术（SIA）后靶病变附近和靶病变内侧支血管的命运。方法：回顾性分析了3年内29例接受下肢动脉SIA的患者术前和术后的血管造影。记录术前和术后闭塞近端≤5 cm（近段）和闭塞远端≤5 cm（远段）的通畅侧支血管数量并进行比较。此外，对SIA后再通段内重新开放的侧支血管数量进行计数。结果如下：术前和术后近段侧支通畅的平均数分别为1.9（范围0-4）和1.4（范围0-4）（p<0.002）。术前远端段的平均通畅侧支血管数量为1.9（范围0-4），术后为1.0（范围0-4）（p<0.0001）。SIA后，在29例患者中的4例（14%）中观察到再通节段内先前不存在侧支循环。所有3个节段（近端、治疗段和远端）内的侧支血管平均数量术前为3.9条，术后为2.9条。结论：SIA过程中牺牲了一些侧支血管，但大多数侧支血管得以保留。此外，SIA有可能在闭塞段内打开新的侧支循环。如果靶段内发生再狭窄，这些侧支可能发挥重要作用。
Purpose: To evaluate the fate of collateral vessels adjacent to and within the target lesion following subintimal angioplasty (SIA). Methods: Pre and postprocedural angiograms were reviewed for 29 patients undergoing SIA of the lower extremity arteries over a 3-year period. The number of patent collateral vessels ≤5 cm proximal to the occlusion (proximal segment) and ≤5 cm distal to the occlusion (distal segment) were recorded pre and postprocedurally and compared. In addition, the number of collateral vessels that were re-opened within the recanalized segment following SIA was counted. Results: The mean number of patent collaterals in the proximal segment was 1.9 (range 0–4) preprocedurally and 1.4 (range 0–4) postprocedurally (p<0.002). The mean number of patent collaterals in the distal segment was 1.9 (range 0–4) pre-procedurally and 1.0 (range 0–4) postprocedurally (p<0.0001). Previously absent collaterals within the recanalized segment were observed in 4 (14%) of 29 patients post-SIA. The mean number of collateral vessels within all 3 segments (proximal, treated, and distal) was 3.9 collaterals preprocedurally and 2.9 collaterals postprocedurally Conclusions: Some collateral vessels are sacrificed during SIA, but the majority are preserved. In addition, SIA has the potential to open new collaterals within the occluded segment. These collaterals may play an important role should restenosis develop within the target segment.