Watson H R, Schroeder T V, Simms M H, Buth J, Horrocks M, Norgren L, Bergqvist D
Schering AG, Berlin, Germany.
Eur J Vasc Endovasc Surg. 1999 Jan;17(1):77-83. doi: 10.1053/ejvs.1998.0712.
To investigate the relationship between bypass patency, limb survival and clinical symptoms after femorodistal bypass procedures.
Multicentre, prospectively planned 12-month postoperative follow-up.
Five hundred and seventeen patients undergoing femorodistal bypass surgery for severe ischaemia. Clinical symptoms, bypass patency were recorded at regular intervals up to 12 months postoperatively.
Complete follow-up data was obtained on 498 patients (96%). Fifty-six (17%) of the 341 patients with patent bypasses had either rest pain or ulcers or had undergone major amputation at 12 months. Of the 167 patients with an occluded bypass, 22 patients (13%) had improved clinical symptoms and a total of 59 patients (35%) had avoided major amputation at 12 months. The clinical outcome for patients classified preoperatively as Fontaine stage IV was significantly worse than for those in stage III preoperatively despite similar bypass patency rates.
There is a fair correlation between technical and clinical outcome after femorodistal bypass surgery at 12 months, but there are significant numbers of patients with occluded bypasses who have a good clinical outcome and of patients with patent bypasses who have a poor clinical outcome. The reporting of symptoms in addition to bypass patency would aid the interpretation of surgical results.
研究股腘动脉搭桥术后搭桥血管通畅情况、肢体存活情况与临床症状之间的关系。
多中心、前瞻性计划的术后12个月随访。
517例因严重缺血接受股腘动脉搭桥手术的患者。术后定期记录临床症状及搭桥血管通畅情况，直至术后12个月。
获得了498例患者（96%）的完整随访数据。在341例搭桥血管通畅的患者中，56例（17%）在12个月时出现静息痛或溃疡，或接受了大截肢手术。在167例搭桥血管闭塞的患者中，22例（13%）临床症状改善，共有59例（35%）在12个月时避免了大截肢手术。术前分类为Fontaine IV期的患者临床结局明显差于术前III期患者，尽管搭桥血管通畅率相似。
股腘动脉搭桥术后12个月时技术结果与临床结局之间存在一定相关性，但有相当数量搭桥血管闭塞的患者临床结局良好，也有相当数量搭桥血管通畅的患者临床结局较差。除了报告搭桥血管通畅情况外，报告症状将有助于对手术结果的解读。
