대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제82권3호
  • /
  • Pages.500-511
  • /
  • 2021
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  • 1738-2637(pISSN)
  • /
  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
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하지동맥 질환의 인터벤션: 전반적 치료 계획 수립

General Treatment Strategy for Intervention in Lower Extremity Arterial Disease

  • 원제환 (아주대학교 의과대학 아주대학교병원 영상의학과)
  • Je Hwan Won (Department of Radiology, Ajou University College of Medicine, Ajou University Hospital)
  • 투고 : 2021.03.18
  • 심사 : 2021.04.17
  • 발행 : 2021.05.01
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초록

하지동맥 질환의 유병률은 고연령 군에서 증가한다. 최근의 기술적 진보로 혈관 내 치료가 점점 더 많은 빈도로 시행되고 있다. 간헐적 파행의 치료 목표는 보행 능력을 향상시키고 증상을 완화시키는 것이다. 이를 위해 해부학적 내구성을 높이는 것이 중요한 전략이며 개통률이 치료 평가 기준이 된다. 임계 하지허혈을 가진 환자에서는 병변이 광범위하고 특히 무릎아래동맥을 심하게 침범한다. 임계 하지허혈의 치료 목적은 상처 회복을 촉진하고 주요 절단을 예방하는데 있으며 사지 보존율이 평가의 기준이 된다. 장골동맥 협착의 치료에는 피복 혹은 비피복 스텐트 삽입술이 일차적 치료로 인정된다. 대퇴슬와동맥 질환은 죽종제거술과 함께 약물방출풍선 및 스텐트가 자주 사용되는 반면 무릎아래동맥 질환에서는 풍선확장술이 주요 치료 방법이다. 컴퓨터단층 혈관조영술은 절대적 금기증이 없는 환자에서 혈관 내 치료계획 수립을 하는데 로드맵을 제공한다.

The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications.

키워드

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