[1]孙 元,张喜成,胡 波,等.光学相干层析成像在下肢动脉斑块定向旋切术中应用探讨[J].介入放射学杂志,2026,(06):608-612.[doi:10.3969/j.issn.1008-794X.2026.06.006 ]
　SUN Yuan,ZHANG Xicheng,HU Bo,et al.Application of optical coherence tomography in directional atherectomy for lower limb arterial plaques[J].J Intervent Med,2026,(06):608-612.[doi:10.3969/j.issn.1008-794X.2026.06.006 ]
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光学相干层析成像在下肢动脉斑块定向旋切术中应用探讨()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年06
页码:
608-612
栏目:
血管介入
出版日期:
2026-06-17

文章信息/Info

Title:
Application of optical coherence tomography in directional atherectomy for lower limb arterial plaques
文章编号:
1008-794X(2026)-006-0608-05
作者:
孙 元;  张喜成;  胡 波;  李观强;  陈 明;  黄献琛
215000 江苏苏州 苏州大学附属第四医院血管外科与介入科
Author(s):
SUN Yuan; ZHANG Xicheng; HU Bo; LI Guanqiang; HUANG Xianchen.
Department of Vascular Surgery and Intervention,The Fourth Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215000,China
关键词:
光学相干层析成像;  定向斑块旋切术;  动脉硬化闭塞症
分类号:
R654.3
DOI:
10.3969/j.issn.1008-794X.2026.06.006
文献标志码:
A
摘要:
目的 探讨光学相干层析成像(optical coherence tomography,OCT)在定向斑块旋切术(directional atherectomy,DA)治疗股腘动脉硬化闭塞症中的作用。方法 选择11例拟接受DA治疗的股腘动脉硬化闭塞症患者。在采用TurboHawk外周斑块旋切系统进行常规旋切后,对靶病变动脉分别行DSA和OCT检查。根据OCT测定旋切后血管直径和管腔获得面积,判断旋切效果,确定是否需要补切或补救性植入支架等。结果 DA手术均获成功,手术时间(172.08±31.74)min。OCT测量显示,旋切前靶病变段管腔面积为(3.15±1.53)mm2,第1轮旋切后靶病变管腔获得面积为(10.59±3.93)mm2。DSA检查显示7例患者靶病变管腔全程未见>30%残余狭窄,但OCT显示仅2例患者全程残余狭窄<30%,其余9例有明显的偏心性残余狭窄。根据OCT定位,9例患者残余狭窄部位再次接受定向旋切,旋切前后靶病变管腔获得面积分别为(8.49±1.57)mm2、(11.26±2.44)mm2。本组中术后2例患者出现局限性夹层,4例可见血管中膜损伤,无血管穿孔和补救性支架植入。随访19～47个月,12个月靶病变再狭窄率为1/11,36个月累计再狭窄3例。术后12个月跛行距离及踝肱指数与术前相比均显著改善,随访期间无非预期截肢及死亡患者。结论 OCT引导下DA可显著提高术中靶病变管腔获得面积,减少残余狭窄,降低血管损伤等并发症发生率。

参考文献/References:

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[7]贾中芝,王 凯,蒋国民.SilverHawk斑块旋切治疗支架闭塞导致支架破损一例[J].中华医学杂志,2017,97:789-790.
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(收稿日期:2025-04-08)
(本文编辑:谷 珂)

相似文献/References:

[1]蔡志文,谷涌泉.定向斑块旋切联合药物涂层球囊治疗股腘动脉病变进展 [J].介入放射学杂志,2019,28(03):301.
　CAI Zhiwen,GU Yongquan..Directional atherectomy combined with drug- coated balloon dilatation for femoropopliteal artery diseases： recent advances in research[J].J Intervent Med,2019,28(06):301.

备注/Memo

备注/Memo:
基金项目: 江苏省苏州市科技计划项目(SZM2022021)
通信作者: 黄献琛 E-mail:xchuang@suda.edu.cn
更新日期/Last Update: 2026-05-25