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Objective: To report subintimal angioplasty (SIA) treatment of arteriosclerosis obliterans method and analyze its clinical efficacy. Methods: From September 2006 to September 2007 , the application of SIA treat arteriosclerosis obliterans patients 12 cases , a total of 12 limbs , including three cases of iliac artery occlusion , femoral artery, popliteal artery in 4 cases, distal knee small arteries ( anterior tibial , posterior tibial , peroneal artery ) in 5 cases, in the DSA room, supine, local anesthesia ipsilateral antegrade or retrograde femoral artery puncture , placement 6F sheath catheter inserted after 4F Duo Gongneng , 0.035 guidewire , because the lumen is completely occluded , the guide wire can not be true lumen across the narrow section , now available guidewire , catheter cooperate, under the supervision of adjustments in the perspective of the catheter , guide wire , entered the middle of arterial plaque Yu room , when crossed stenosis after adjustment catheter, guide wire direction re-enter the true lumen catheter removal , cis balloon guidewire into a suitable size to 709 ~ 811kPa pressure line of balloon angioplasty , repeatable implementation , balloon angiography again after expansion , according to the occlusion patency decide whether placed self-expanding nitinol stent . Review the ankle-brachial index and postoperative follow-up , clinical efficacy . Results : The group of 12 patients , 11 cases achieved technical success , the success rate was 91.7%. Artery in 12 patients does not appear serious complications such as perforation , 1 case of subcutaneous hematoma. Clinical symptoms in varying degrees of improvement , review ankle-brachial index averaged 0.82 ( 0.25 to 1.08 ) , and preoperative ankle-brachial index 0.28 ( 0.14 to 0.43 ) and there was significant difference (P <0.01). Patients were followed up for a successful surgery to 12 months ( mean 6 months ) , except one case of postoperative thrombosis of the lower extremities following day , one case of amputation surgery in August , the remaining nine cases remain open. Conclusion : SIA is the treatment of arteriosclerosis obliterans a new method , and safe , minimally invasive , simple operation, short-term effect is satisfactory, but there is still a new technology as it needs to continue to refine and improve the local , long-term patency rates requires further study and discussion.
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