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Objective:To evaluate the safety and efficacy of a combination of percutaneous mechanical thrombectomy (PMT) and drug coated balloon(DCB)for the treatment of in-stent restenosis(ISR) and arterial thrombosis of the lower extremity.Methods:The clinical data of 53 patients treated with PMT + DCB were analyzed retrospectively, including 38 cases of ISR and 15 cases of arterial thrombosis. 33 patients were males and the others were females , the mean age was (68.6±9.4) years . Patients were followed at 30 days, 6 months, and 12 months concerning clinical symptoms, calculation of ABIs and duplex ultrasonography.Results:Procedural success was achieved in all 53 patients. One patient died of cardiovascular event perioperatively. 6 operation-related complications occurred including 5 cases of distal embolism during the PMT managed by using 5 F angiography catheter suction and one case of artery perforation during PMT procedure, a balloon was used to cover it. 47 (88.6%) patients completed 12-month follow-up, the TLR was 10.6% (5/47). One patient had the amputation 4 months later; There were 7 cases with arterial restenosis.PMT+ DCB were performed again in 4 cases, 1 case received stent implantation and 2 cases treated by medication.Conclusion:The use of combination of PMT and DCB is a safe and effective method to treat ISR and arterial thrombosis of the lower extremity.
RESUMO
Objective To explore the role and clinical efficacy of catheter induced thrombolysis (CDT) debulking method in the treatment of aorto-iliac artery occlusion.Methods A total of 59 patients with aorto-iliac artery occlusion who underwent endovascular treatment between June 2015 and June 2017 were enrolled.Patients were divided into PTA group and CDT group according to the treatment methods received.The PTA group received a balloon-expandable stent placement,and the CDT group underwent thrombolytic therapy for 48 to 72 hours before angiographic evaluation and further PTA treatment.Results In the CDT group,7 cases were still unable to place the stent after thrombolysis,and 20 patients successfully received stenting including 1-stent-placement in 16 patient and 2-stents-placement in 4.In PTA group 32 patients were treated with stents placement including 1-stent-placement in 19 patients,2-stents in 12,3-stents in 1.Follow-up rate was 86.3％ within 1 year,the patency rate was 84.21％ in the PTA group,and 76.92％ in the CDT group.Conclusions CDT is effective method for occlusion of the aortoiliac artery.TASC classification of aorto-iliac arterial occlusion degrades after CDT treatment,thus reducing the use of stenting.