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下肢动脉硬化闭塞症股动脉长段闭塞的治疗进展
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Abstract:
下肢动脉硬化闭塞症(ASO)股动脉长段闭塞的治疗需基于病变特征及患者个体情况制定综合策略。基础干预强调生活方式管理，包括控制心血管危险因素(如血糖、血压、血脂)及戒烟，以延缓疾病进展。药物治疗以抗血小板和抗栓治疗为核心，结合新型抗栓方案以降低不良事件风险。腔内治疗技术(如药物涂层球囊、覆膜支架)因微创优势被广泛用于中短段病变，而长段闭塞常需联合减容技术(斑块旋切、激光消融)以优化疗效。外科手术(旁路移植、内膜剥脱)仍是复杂病变(如TASC D型)的首选，杂交手术则通过结合微创与开放术式，平衡疗效与创伤。当前治疗趋势倾向于多模式联合应用，以延长血管通畅时间并减少并发症。未来需进一步探索生物可吸收支架等新技术，以提升治疗安全性和长期预后。
The management of long-segment femoral artery occlusion in lower extremity arteriosclerosis obliterans (ASO) requires a comprehensive strategy tailored to lesion characteristics and individual patient profiles. Foundational interventions emphasize lifestyle modifications, including control of cardiovascular risk factors (e.g., blood glucose, blood pressure, lipids) and smoking cessation, to slow disease progression. Pharmacotherapy focuses on antiplatelet and antithrombotic agents, augmented by novel regimens to reduce adverse events. Endovascular techniques (e.g., drug-coated balloons, covered stents) are widely adopted for short-to-medium lesions due to their minimally invasive nature, while long-segment occlusions often necessitate adjunctive debulking technologies (e.g., atherectomy, laser ablation) to enhance outcomes. Open surgeries (bypass grafting, endarterectomy) remain primary for complex lesions (e.g., TASC D), whereas hybrid procedures integrate minimally invasive and open approaches to balance efficacy and invasiveness. Current trends favor multimodal combinations to prolong vascular patency and minimize complications. Future advancements, including bioresorbable stents, aim to improve safety and long-term outcomes.
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