摘要目的：探讨经腘动脉入路逆行治疗同侧股腘动脉长段慢性完全闭塞性病变（Chronic total occlusion，CTO）的可行性及应用价值。方法：回顾性分析26例经腘动脉入路逆行治疗股腘动脉长段CTO患者临床资料，分析并总结腘动脉穿刺技术成功率、血管开通率、并发症和近期疗效。结果：腘动脉穿刺技术成功率及血管开通率均为100%，术后临床症状明显改善，踝肱指数（ABI）由术前的0.32±0.13上升为0.82±0.15（P＜0.05）。5例出现腘动脉穿刺点相关并发症，其中腘动脉假性动脉瘤1例，腘动静脉瘘1例，穿刺点周围血肿3例。术后6月4例出现支架再狭窄或闭塞，支架一期通畅率为84.6%（22/26）。结论：经腘动脉入路逆向开通是一种安全和有效的方法，可作为股腘动脉长段CTO顺行开通失败后的首选补救手段。
Abstract：Objective: To investigate the feasibility and application value via the popliteal artery for treating long and chronic total occlusions(CTO) in ipsilateral femoral-popliteal arteries. Methods: A retrospective analysis was undertaken of 26 patients who underwent retrograde recanalization via a popliteal artery access for long and CTO in ipsilated femoral-popliteal arteries. Success rate of retrograde puncture and femoral-popliteal artery recanalization were summarized. The complications and short-term clinical efficacy were also analyzed． Results: Technical success(puncture of the popliteal artery and femoral-popliteal artery recanalization) was achieved in all cases. The clinical symptoms improved significantly after operation. Compared with pre-procedure data, the ankle-brachial index(ABI) increased significantly from 0.32±0.13 to 0.82±0.15(P<0.05). Perioperative complications related to popliteal access included 1 pseudoaneurysm， 1 arterio-venous fistula and 3 hematomas in the popliteal region. Restenosis or occlusion were found in 4 patients during 6 months following-up. The primary patency at 6 months was 84.6%(22/26). Conclusion: Retrograde approach via the popliteal artery is a safe and effective technique for long and CTO in femoral-popliteal arteries, which can be considered as first choice after failed antegrade recanalization.
郑加贺，畅智慧，王传卓，刘兆玉，郭启勇. 经腘动脉入路逆行治疗同侧股腘动脉长段慢性完全闭塞性病变[J]. 中国临床医学影像杂志, 2017, 28(2): 133-136.
ZHENG Jia-he, CHANG Zhi-hui, WANG Chuan-zhuo, LIU Zhao-yu, GUO Qi-yong. Retrograde approach via the popliteal artery for treating long and #br#
chronic total occlusions in ipsilateral femoral-popliteal arteries. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(2): 133-136.
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