Schneider J R, Zwolak R M, Walsh D B, McDaniel M D, Cronenwett J L
Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756.
J Vasc Surg. 1991 Jun;13(6):785-90; discussion 790-1. doi: 10.1067/mva.1991.28087.
This study examined the relationship between graft diameter and subsequent patency in 79 patients who received Dacron aortobifemoral bypass grafts for aortoiliac occlusive disease between 1985 and 1989. Sixty-five percent of these patients were men, 25% were diabetic, and 94% were smokers, with an average age of 62 years. Patients were followed for a mean interval of 24 months. Life-table survival was 92% at 3 years. All surviving patients showed "significant" postoperative improvement by use of Society for Vascular Surgery/International Society for Cardiovascular Surgery combined clinical and vascular laboratory criteria. There were three early and five late graft thromboses. Primary and secondary life-table patencies were 85% and 92%, respectively, at 3 years. Dacron bifurcation grafts were selected to match the size of native arteries. Patients receiving small diameter grafts, defined as 12 mm (n = 9) and 14 mm (n = 39), were compared with patients receiving large diameter grafts of 16 mm (n = 26) and 18 mm (n = 5). Small diameter grafts were more likely to be used in women (p less than 0.01), but patient groups were otherwise comparable with respect to age, smoking history, diabetes, outflow status, operative indications, type of proximal anastomosis (end-to-end or end-to-side), location of distal anastomosis (common femoral vs deep femoral), type of graft construction (knitted vs woven), and functional result. Graft diameter did not influence life-table patency, which was 84% for small and 87% for large diameter grafts at 3 years (p = 0.74). Furthermore, none of the other variables listed above influenced graft patency.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究调查了1985年至1989年间因主髂动脉闭塞性疾病接受涤纶材质主-双股动脉搭桥移植术的79例患者的移植血管直径与后续通畅情况之间的关系。这些患者中65%为男性,25%患有糖尿病,94%为吸烟者,平均年龄62岁。患者平均随访24个月。3年时生命表生存率为92%。所有存活患者根据血管外科学会/国际心血管外科学会联合临床和血管实验室标准显示术后有“显著”改善。有3例早期和5例晚期移植血管血栓形成。3年时原发性和继发性生命表通畅率分别为85%和92%。选择涤纶分叉移植血管以匹配天然动脉的大小。将接受定义为12毫米(n = 9)和14毫米(n = 39)的小直径移植血管的患者与接受16毫米(n = 26)和18毫米(n = 5)的大直径移植血管的患者进行比较。小直径移植血管更常用于女性(p < 0.01),但在年龄、吸烟史、糖尿病、流出道状况、手术指征、近端吻合类型(端端或端侧)、远端吻合位置(股总动脉与股深动脉)、移植血管构造类型(针织与编织)和功能结果方面,患者组在其他方面具有可比性。移植血管直径不影响生命表通畅率,3年时小直径移植血管的通畅率为84%,大直径移植血管为87%(p = 0.74)。此外,上述其他变量均不影响移植血管通畅率。(摘要截短于250字)