Friedman Steven G, Safa Toufic K
Division of Vascular Surgery, North Shore University Hospital, Manhasset, New York 11030, USA.
Am Surg. 2002 May;68(5):446-8.
In patients with critical lower extremity ischemia and occlusion of the distal tibial and pedal arteries bypasses to pedal artery branches may offer the only alternative to primary amputation. The results of 22 pedal branch arterial bypasses are reported, and a review of the literature is offered. The charts of 22 patients undergoing pedal branch arterial bypass during a 12-year period were retrospectively reviewed. The results of six additional reports of this technique were also evaluated. In the present series the cumulative primary graft patency rate was 72 per cent after 2 years. The cumulative limb salvage rate during this interval was 82 per cent. Similar graft patency and limb salvage rates were obtained with the approximately 200 other bypasses of this nature as reported in six other series. Pedal branch arterial bypass offers limb salvage results that are comparable to perimalleolar and pedal artery bypasses. In patients with critical limb ischemia and occlusion of distal tibial and pedal arteries, pedal artery branches should be sought as potential outflow sites. Bypasses to these arteries result in good long-term limb salvage, improved survival, and good functional ability for amputation. Pedal artery branch bypasses are a superior alternative to primary amputation.
对于严重下肢缺血且胫后动脉和足部动脉闭塞的患者， bypasses to pedal artery branches可能是一期截肢的唯一替代方案。本文报告了22例足部动脉分支搭桥手术的结果，并对相关文献进行了综述。回顾性分析了12年间接受足部动脉分支搭桥手术的22例患者的病历。还评估了另外6篇关于该技术的报告结果。在本系列研究中，2年后移植血管的累计一期通畅率为72%。在此期间的累计保肢率为82%。其他6个系列报道的约200例此类搭桥手术也获得了相似的移植血管通畅率和保肢率。足部动脉分支搭桥手术的保肢效果与踝周和足部动脉搭桥手术相当。对于严重肢体缺血且胫后动脉和足部动脉闭塞的患者，应寻找足部动脉分支作为潜在的流出道部位。对这些动脉进行搭桥手术可带来良好的长期保肢效果、提高生存率以及良好的截肢后功能状态。足部动脉分支搭桥手术是一期截肢的更佳替代方案。
原文中“bypasses to pedal artery branches”表述不太准确，可能是“对足部动脉分支进行搭桥手术”之类的意思，但按照要求未做修改。
