Preliminary application of intravascular ultrasound in the treatment of complex lower extremity arterial diseases

Objective： To explore the value of intravascular ultrasound (IVUS) for endovascular reconstruction techniques in treating complex lower extremity arterial occlusive diseases. Methods： From February 2013 to December 2014, 12 patients with lower extremity arterial complex lesions were treated by digital subtraction angiography (DSA) and with IVUS guided application of vascular interventional technique before and after vascular reconstruction. Results： All patients were successfully examined by IVUS, and IVUS played a key role in the decision-making of the interventional procedure. One case of popliteal artery entrapment syndrome thrombosis lesion was treated by simple thrombolysis; 2 cases of in-stent restenosis diagnosed as thrombosis and intimal hyperplasia, which were treated with balloon expansion after thrombolysis; 1 case with stent restenosis was treated with thrombolysis, and at the same time, distal residual stenosis was found and stent graft was implanted during the second stage; 7 cases of arteriosclerosis obliterans: 2 cases, diagnosed as thrombosis and stenosis, were performed thrombolysis and then balloon expansion, and 5 cases, long chronic total occlusion lesions, were treated with balloon expansion and then implanted stent; 1 case of iliac artery lesions was used covered stent. The postoperative follow-up time was 6-18 months, the average follow-up time was (9.7±3.7) months, and the primary patency rate of six months was 100%. Conclusions： In the diagnosis and treatment of complex peripheral arterial occlusive disease, IVUS can help achieve a more accurate observation of the pathological changes of blood vessels, optimize balloon and stent selection and positioning, evaluate treatment satisfaction, and reduce and prevent complications.