슬와동맥 P2와 P3분절의 협착 및 폐쇄 병변에 Cutting Balloon을 이용한 경피적혈관성형술의 초기결과보고 = Early Results of Cutting Balloon Angioplasty for the Treatment of Stenoocclusive Lesions of Popliteal Arterial Segments P2 and P3

다국어 초록 (Multilingual Abstract)

Purpose: To report the early results of a cutting balloon angioplasty (CBA) procedure for the treatment of stenoocclusive lesions of popliteal arterial segments P2 and P3.
Materials and Methods: Between August 2005 and August 2008, 11 patients underwent CBA due to stenoocclusive lesions of popliteal arterial segments P2 and P3 (Diameter ≥ 4.6 mm). All procedures were performed percutaneously and a PTA was performed by cutting 5mm diameter balloons. An arteriography was performed after each CBA to evaluate the results of the angioplasty and to look for complications, such as elastic recoil or flow-limiting dissection. A follow-up examination was performed at 6 and 12 months.
Results: The CBA was technically successful in all cases, thus resulting in the reduction or elimination of clinical symptoms at the 6-month follow-up. One patient showed dissection without flow limitation, but no complications developed. In addition, there was no need for stent placement. Primary patency was 82% and 71.5% at the 6- and 12-month follow-up examinations, respectively.
Conclusion: From the patients examined, a CBA is a safe and effective method for treating stenoocclusive lesions of popliteal arterial segments P2 and P3. In addition, it may serve as a means to reduce complications and the need for stent placement after a PTA at a site that is not ideal for stent placement.

국문 초록 (Abstract)

목적: 슬와동맥 P2와 P3분절의 협착 또는 폐쇄가 있는 환자에서 cutting balloon을 이용한 경피적혈관성형술(PTA)을 시행하였고 그 초기 결과를 보고하고자 한다.
대상과 방법: 2005년 8월부터 2008년 8월까지 협착 및 폐쇄가 있는 슬와동맥 P2와 P3 분절의 직경이 4.6 mm이상이어서 5 mm직경의 cutting balloon을 사용할 수 있는 11명의 환자를 대상으로 하였다. 환자들은 간헐적 파행(n=9)과 족부 궤양 (n=2)이 주증상이었다. 모든 병변 부위를 유도철사로 통과시킨 후 cutting balloon을 이용하여 PTA를 시행하였다. 시술 직후 혈관촬영술을 통하여 초기 합병증의 유무와 협착 및 폐쇄가 소실되었는지를 알아보았고 추적관찰기간 동안 임상증상의 호전 여부와 영상검사를 통하여 재협착이 발생하였는지를 알아보았다.
결과: 모든 환자에서 시술은 성공하였으며, 시술 후 협착 및 폐쇄는 모두 소실되었고 임상증상도 호전되었다. 1명의 환자에서 혈관박리가 있었으나 혈류를 방해하지 않았으며 모든 환자에서 스텐트 삽입술을 필요로 하는 합병증은 없었다. 추적 관찰기간 동안 슬와동맥의 6개월 개통률은 82%(9/11), 1년 개통률은 71.5%(5/7)의 결과를 보였다.
결론: Cutting balloon을 이용한 PTA는 슬와동맥의 P2와 P3 분절의 폐쇄 및 협착에 안전하고 성공률이 높은 치료방법이며, 고식적 PTA의 합병증인 혈관박리와 탄성재수축을 줄이는 것을 통하여 스텐트 삽입술이 적절치 않은 부위의 치료에 좋은 대안이 될 수 있으리라 생각된다.

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