膝下血管腔内治疗策略ppt课件

1、庄百溪 患病率升高 老龄化年代、糖尿病人、不良生活习惯导致动脉硬化发生率增高 发病率升高 检查手段改善，更多的发现膝下病变 就诊多为晚期 患者知晓率低，医师敏感度差 闭塞动脉开通率低 多为多支长段严重钙化的闭塞 经济负担重放置支架的能够性增大、忍受苦楚截肢、截趾发生率高 通常对间歇性跛行患者不实施膝下腔内治疗 Use of this technique is usually not indicated in patients with intermittent claudication TASC II F3.2 Endovascular treatment of infrapopliteal

2、occlusive disease 冠心病的治疗战略： 心梗？心绞痛！ 下肢也一样！ 狭窄性病变、单支病变就应该积极治疗，尤其伴有糖尿病的患者 像注重心脏一样注重足！ 由于膝下血管管径较小，一旦开展为完全闭塞，再次开通的时机将大大降低，给临床任务带来极大的困难 短段病变如没有被积极治疗，会逐渐在远近端构成血栓，进而机化，进展为长段完全闭塞，给治疗带来更多困难 所以，我们应该提倡及早治疗血管病变从手术角度也要求及早治疗膝下血管病变常见膝下病变类型 尽能够采用同侧顺行穿刺，可获得更佳的导丝操控性 伴有髂股动脉病变的患者，可采用对侧穿刺，方便同期治疗髂、股腘动脉病变 三支血管各有作用，当某一支血管病

3、变时，相应供血区域会出现病症 尤其伴有糖尿病患者，侧枝循环较差，更易出现仅单支血管病变就导致CLI的景象 术中尽能够开通全部病变血管，建立直达足部血流in-line flow to the footDPATDPAT术前扩张后支架后术前球扩后支架后 足底、足背动脉弓的重要意义 腔内治疗膝下血管病变应早期诊断，早期治疗 术中尽能够开通全部病变血管，建立直达足部血流in-line flow to the foot 注重足底动脉弓及足背动脉弓 多学科协作，注重预防和治疗BAIXI ZHUANG High Morbidity rate aging、diabetic、food and drink had

4、made more arteriosclerosis High Morbility rate advanced method can find more BTK lesion Most patients were CLI poor awarenes，doctor pay less attention Hard to open occlusion multi-branch, long segment, severe cacification Charge will higherPossibility of stent is higher、suffer painhigher amputation

5、rate Angioplasty of a short anterior or posterior tibial artery stenosis may be performed in conjunction with popliteal or femoral angioplasty. Use of this technique is usually not indicated in patients with intermittent claudication. TASC II F3.2 Endovascular treatment of infrapopliteal occlusive d

6、isease Strategies about coronary artery disease： myocardial infarct？angina pectoris！ The same to leg！ stenosis、single lesion should be treated in time, especially for diabetic Treat foot like treat heart！Common BTK lesion Antegrade puncture as posible as you can，you can control the wire more easy Ea

7、ch branch has its role. Lesion in one branch may induce CLI in corresponding supply area, especially in people with diabetes for the lack of collateral circulation We should made in-line flow to the foot!DPATDPAT术前扩张后支架后术前球扩后支架后 Status of pedal and plantar arch very important The earlier the better We should made in-line flow to the foot Status of pedal