Siani A, Schioppa A, Flaishman I, Zaccharia A
Ospedale S. Pietro-Fatebenefratelli, Roma, U.O.C. Chirurgia Vascolare, Italy.
G Chir. 2006 Jan-Feb;27(1-2):63-5.
The Authors report their experience in the management of acute lower limbs ischemia through distal popliteal artery approach.
Five popliteal embolectomy through a medial approach were performed; in one patient a posterior approach was carried out. Patients were included in two groups on the basis of ischemia duration: group A<6 hours (3 patients) and group B>6 hours (3 patients). Colour-duplex scan was performed in all the patients The arteriotomy was closed with interrupted 7/0 monofilament polypropylene sutures.
There were no peri-operative deaths. The primary limb salvage rate was 83.3% (5 patients). In one case (16.7%) a major amputation was performed. In one case (16.7%) a drop foot occurred.
The popliteal embolectomy is followed by excellent results and should be consider prior to thrombolysis or bypass graft revascularization. An appropriate use of duplex scan and a medial approach can lead to an high successful rates in terms of limb function and limb salvage also in cases with delayed ischemia.
作者报告了他们通过腘动脉远端入路治疗急性下肢缺血的经验。
通过内侧入路进行了5例腘动脉取栓术;1例患者采用了后侧入路。根据缺血持续时间将患者分为两组:A组<6小时(3例患者)和B组>6小时(3例患者)。所有患者均进行了彩色双功超声扫描。动脉切口用7/0单丝聚丙烯缝线间断缝合。
无围手术期死亡。主要肢体挽救率为83.3%(5例患者)。1例(16.7%)进行了大截肢。1例(16.7%)出现垂足。
腘动脉取栓术效果良好,在溶栓或旁路移植血管重建之前应予以考虑。在缺血延迟的病例中,合理使用双功超声扫描和内侧入路可在肢体功能和肢体挽救方面取得较高的成功率。