关键词: 动脉粥样硬化, 2 型糖尿病, 腔内成形术, 流出道评分, 一期通畅率

Abstract: Objective To evaluate the implication of runoff score on the primary patency of femoropopliteal angioplasty in patients with type 2 diabetes mellitus, using the Society for Vascular Surgery (SVS) criteria. Methods A retrospective review of a database of 37 patients with type 2 diabetes mellitus (41 legs) undergoing femoropopliteal angioplasty between 2006 January and December 2010 was made. Demographic characteristics and possible related diseases were recorded. Procedural angiograms were classified according to TASC Ⅱ criteria. SVS runoff scores were determined after the completion of the intervention and the primary patency were calculated. Cox proportional hazard model was used to determine if runoff score and other factors affected the outcome. Results Thirty seven patients(41 legs) were included. Among the 41 legs, 22 underwent bare metal stent implantation. Twenty two legs underwent tibial angioplasty successfully. According to TASC Ⅱ, the lesion severity scores were: TASC Ⅱ A 22 legs, TASC Ⅱ B 19 legs. Post-procedural runoff score: 1~3, 3 legs; 3.5~5, 7 legs; 5.5~7, 15 legs; 7.5~10, 16 legs. The median runoff score was 7 (ranged from 1 to 9.5). Follow-up time ranged from 1 month to 48 months (median 12 months). 95.1% patients were fully followed. Two patients were lost. The total primary patency rates at the 1, 3, 6 months and 1, 2, 3 years were 95.0%,92.5%, 92.5%,77.4%,65.3% and 45.5% respectively. By Cox regression analysis, post-procedural runoff score according to SVS criteria affected primary patency significantly (RR=1.857,P=0.003,95%CI:1.230~2.806). Conclusion Compromised runoff negatively affected the primary patency of femoropopliteal angioplasty. High post-procedural runoff score is a main risk factor related to loss of primary patency.

Key words: atherosclerosis, type 2 diabetes mellitus, angioplasty, runoff score, primary patency