Application of subintimal angioplasty for long segment occlusion of superficial femonal artery in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To discuss the clinical value of subintimal angioplasty (SIA) in treating long segment occlusion of superficial femoral artery (SFA) in the elderly,and to observe the follow-up results.Methods Subintimal angioplasty was performed in 66 elderly patients with stage Ⅱ-Ⅳ long segment occlusion of SFA.The improvement of ankle-brachial index (ABI) and the long-term patency rates were observed and analyzed before and after treatment.Results Of 66 elderly patients,the surgery was successfully performed in 64 cases (97 ％).Skin temperature was improved,the claudication disappeared or a claudication distance was prolonged,the rest pain disappeared or relieved,foot infection was under control and turned into the dry gangrene in these patients.SIA was given up in 1 case because the wire failed to return to the true lumen and the distal outflow segment was occluded.One patient underwent bypass grafting instead of SIA because the wire failed to get into the subintimal.The ABI got obvious improvement before and after treatment (0.59±0.16 vs.0.84± 0.21,P＜0.01).The patency rates in 62 patients undergoing SIA at 6,12,24,36 months were 85.5％ (53/62),69.4％ (43/62),54.8％ (34/62) and 48.4％ (30/62) after surgery,and the 3-years limb salvage rate in 62 cases was 96.6％ (60/62).Conclusions Subintimal angioplasty is an effective method for treating long segment occlusion of superficial femoral in elderly patients,and it has the satisfactory long-term follow-up results.