Davidović L B, Lotina S I, Kostić D M, Jakovljević N S, Djorić P P, Rancić D M
Institute of Cardiovascular Diseases, Clinical Centre of Serbia, Belgrade.
Srp Arh Celok Lek. 2000 Jul-Aug;128(7-8):276-80.
Pseudo-occlusion of femoro-popliteal/crural (F-P/Cr) bypass occurs when a patent graft is clinically indistinguishable from a thrombosed graft because of reduced flow [1]. The aim of this paper is the presentation of 24 new cases which, as far as we know, have not been published in Yugoslav medical literature.
The group consisted of 20 men and 3 women (aged 28 to 71 years, mean 61.95) with 24 cases of "pseudo-occlusion" of the F-P/Cr bypass. More details are presented in Tables 1 and 2. Saphenous vein graft was used for the reconstruction in 19 patients, and Dacron in 5 subjects. "Pseudo-occlusion" was symptomatic in all 24 patients. Fifteen patients had pain at rest, seven presented disabling claudication, and 2 foot gangrene. The mean time interval between primary operation and occurrence of new symptoms was 25.41 (4-84) months (Table 2). In 15 patients control angiography showed hemodynamically significant lesions in inflow tract, and in 9 subjects in outflow tract. Of the total number of inflow tract lesions, there were 3 late occlusions of previously implanted aorto-femoral graft (1, 3 and 17, Table 1), and in other 21 patients lesions of the native aorto-iliac segment. In 8 patients with changes in outflow tract, a distal progression of atherosclerotic disease was found, while one patient (number 8) had intraoperative lesion of the popliteal artery with vascular clamp. All 24 patients were treated operatively. The early postoperative result was favourable in all 24 (100%) patients. Patients were followed-up from 3 months to 5 years (mean 29.625 months). In this period one (4.1%) late graft occlusion was followed by major limb amputation. Four (16.6%) patients died with patent graft.
当通畅的股腘/小腿（F-P/Cr）旁路移植血管因血流减少在临床上与血栓形成的移植血管无法区分时，就会发生假性闭塞[1]。本文旨在介绍24例新病例，据我们所知，这些病例尚未在南斯拉夫医学文献中发表。
该组包括20名男性和3名女性（年龄28至71岁，平均61.95岁），共24例F-P/Cr旁路移植血管“假性闭塞”。表1和表2提供了更多详细信息。19例患者使用大隐静脉移植血管进行重建，5例使用涤纶血管。所有24例患者的“假性闭塞”均有症状。15例患者静息时疼痛，7例出现致残性间歇性跛行，2例足部坏疽。初次手术至出现新症状的平均时间间隔为25.41（4 - 84）个月（表2）。15例患者的对照血管造影显示流入道有血流动力学显著病变，9例患者流出道有病变。在流入道病变总数中，有3例先前植入的主-股动脉移植血管晚期闭塞（表1中的病例1、3和17），其他21例患者为天然主-髂动脉段病变。在8例流出道有变化的患者中，发现动脉粥样硬化疾病向远端进展，而1例患者（病例8）在术中腘动脉被血管夹损伤。所有24例患者均接受了手术治疗。所有24例（100%）患者术后早期结果良好。对患者进行了3个月至5年（平均29.625个月）的随访。在此期间，1例（4.1%）移植血管晚期闭塞后行大肢体截肢。4例（16.6%）患者在移植血管通畅的情况下死亡。
