胫后动脉超声造影评估老年下肢动脉硬化闭塞症腔内治疗疗效的研究

Study on evaluation of endovascular treatment efficacy of lower extremity arteriosclerosis obliterans by contrast-enhanced ul-trasound of posterior tibial artery in the elderly

中文关键词: 老年  超声造影  下肢动脉硬化闭塞症  腔内治疗  踝肱指数  灌注参数

英文关键词: elderly  contrast-enhanced ultrasound  arteriosclerosis obliterans  endovascular therapy  ankle-brachial in-dex  perfusion parameter

中文摘要:

      目的 探索胫后动脉超声造影(CEUS)评估老年下肢动脉硬化闭塞症(ASO)患者腔内治疗(EVT)的疗效.方法 回顾性分析2020年1月 2022年3月复旦大学附属华东医院血管外科成功接受EVT的老年ASO患者临床数据.所有患者EVT术前/术后均进行胫后动脉CEUS检查,收集CEUS灌注参数(PPs).比较患者EVT术前/术后PPs及踝肱指数(ABI),并进一步分析PPs与ABI的相关性.结果 最终纳入ASO患者51例,患肢55条(4例行双侧EVT术),年龄66～92岁,平均(75.1±7.1)岁.与EVT术前相比,EVT术后ABI、峰值强度(PI)、斜率(S)、面积(A)、冲刷入面积(AWI)和冲刷出面积(AWO)增加,达峰时间(TTP)及平均通过时间(MTT)减少,差异有统计学意义(P＜0.05).术前S与术前ABI呈中等相关(rs=0.505,P＜0.001).结论 胫后动脉CEUS在评估老年ASO患者EVT疗效方面可能具有一定潜力.

英文摘要:

      Objective To explore the efficacy of contrast-enhanced ultrasound(CEUS)of the posterior tibial artery in evaluating endovascular therapy(EVT)for elderly patients with arteriosclerosis obliterans(ASO).Methods A retrospective analysis was conducted on clinical data from elderly ASO patients who successfully underwent EVT in Department of Ultrasound Medicine of Huadong Hospital,Fudan University from January 2020 to March 2022.All patients underwent posterior tibial ar-tery CEUS examinations before and after EVT,and their CEUS perfusion parameters(PPs)were collected.PPs and ankle-bra-chial index(ABI)were compared before and after EVT.Furthermore,the correlation between PPs and ABI was analyzed.Results A total of 51 ASO patients(55 affected limbs,including 4 patients who underwent bilateral EVT)were finally in-cluded.Their age ranged from 66 to 92 years,with a mean age of(75.1±7.1)years.Compared to preoperative values,post-operative ABI,peak intensity(PI),slope(S),area(A),area wash-in(AWI),and area wash-out(AWO)significantly in-creased,while time to peak(TTP)and mean transit time(MTT)significantly decreased(all P＜0.05).Preoperative S showed a moderate correlation with preoperative ABI(rs=0.505,P＜0.001).Conclusion CEUS of the posterior tibial ar-tery may have certain potential in evaluating the efficacy of EVT in elderly patients with ASO.