用于伴有组织缺损和感染的严重肢体缺血的牛肠系膜静脉移植物（ProCol）
Bovine mesenteric vein graft (ProCol) in critical limb ischaemia with tissue loss and infection.
作者信息
Schmidli J, Savolainen H, Heller G, Widmer M K, Then-Schlagau U, Baumgartner I, Carrel T P
机构信息
Swiss Cardiovascular Center, University Hospital, 3010 Berne, Switzerland.
出版信息
Eur J Vasc Endovasc Surg. 2004 Mar;27(3):251-3. doi: 10.1016/j.ejvs.2003.12.001.
OBJECTIVES
Poor results have been reported following infrainguinal reconstructions using heterogenous grafts. The objective of this study was to assess the use of bovine mesenteric vein (ProCol) graft in patients with critical limb ischaemia (CLI), tissue loss/infection and no autologous vein available for reconstruction.
METHODS
Prospective analysis of 32 patients with CLI and tissue loss/infection, in whom reconstruction with ProCol was undertaken between October 1999 and May 2002.
RESULTS
The primary patency rate was 16% at 1 month. After thrombectomy, the secondary patency rate was 50% at 1 month and 26% at 14 months. No graft infections were seen. Aneurysmal dilatation of the graft occurred in 2 (6%). Limb salvage at 14 months was 47%.
CONCLUSION
In patients with critical limb ischaemia, tissue loss/infection and no available vein, the ProCol graft may be an alternative. However, primary patency is a problem. In situations without tissue loss/infection, where the risk of graft infection is less, prosthetic material may be a better alternative.
目的
已有报道称使用异种移植物进行股动脉以下血管重建的效果不佳。本研究的目的是评估牛肠系膜静脉（ProCol）移植物在严重肢体缺血（CLI）、组织缺损/感染且无可用于重建的自体静脉的患者中的应用情况。
方法
对1999年10月至2002年5月间32例CLI且伴有组织缺损/感染、接受ProCol重建术的患者进行前瞻性分析。
结果
术后1个月时一期通畅率为16%。血栓切除术后，1个月时二期通畅率为50%，14个月时为26%。未见移植物感染。2例（6%）出现移植物动脉瘤样扩张。14个月时肢体挽救率为47%。
结论
对于严重肢体缺血、组织缺损/感染且无可用静脉的患者，ProCol移植物可能是一种选择。然而，一期通畅是个问题。在无组织缺损/感染、移植物感染风险较低的情况下，人工材料可能是更好的选择。
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