关键词: 膝下动脉, 血管成形术, 外周血管疾病, Rutherford

Abstract: Objective To report our experience in treating patients with below-the-knee (BTK) arterial lesions, Rutherford class Ⅱ-Ⅵ, with percutaneous transluminal angioplasty (PTA).Methods A retrospective analysis of BTK arterial angioplasty procedures was performed. Patients were classified according to different Rutherford stages. SVS runoff scores were determined after the completion of the intervention and tansluminal angioplasty (PTA) of infrapopliteal artery for the treatment of patients with lower extremity ischemia at Rutherford Ⅱ-Ⅵ stages. Data of 207 cases who underwent peripheral angioplasties for BTK arterial diseases in 189 patients seen from 2010 to 2014 were collected, stratified by Rutherford class, in two vascular surgery medical centers. Data included primary patency, limb salvage, and target vessels patency assessed by Kaplan-Meier life-table analysis.Results There were 189 patients (mean age 71.33±6.90 years) who received PTA surgeries, including 148 patients with diabetes, 60 smoking, 90 with hyperlipidemia, 124 with hypertension, 58 with coronary artery disease, 21 with renal insufficiency and 30 with cerebral infarction. Rutherford stage Ⅱ- Ⅲ diseases were seen in 45 limbs, stage IV in 21 limbs, and stage V-VI in 91 limbs. At the mid-term follow-up (21.8±5.2 months), the overall death rate was 7.94%. The limb salvage rates of Rutherford class Ⅱ-Ⅲ patients in 1 and 2 years postoperatively were 97.56% and 93.81%, respectively, in class IV patients 92.55% and 87.86%, respectively, and in class V-Ⅵ patients 86.50% and 77.58%, respectively. Primary patency rates the 1st year postoperatively were 86.85%, 67.12%, 38.78% and 65.14%, 54.67%, 37.68% at the 2nd years. Conclusion Our results showed that the patency rate as an intermediate clinical outcome of infrapopliteal PTA was low. But it had higher limb salvage rate and higher symptoms relief rate. These data suggested that PTA should be considered as initial therapy for treatment of below-the-knee lesion.

Key words: inferior genicular artery, angioplasty, peripheral arterial disease, Rutherford