Sitrângulo Júnior C, Langer B, Kauffman P, Bouabci A S, Aguiar E T, Cinelli Júnior M
Disciplina de Cirurgia Vascular, Faculdade de Medicina, Universidade de São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1991 Mar-Apr;46(2):63-73.
From October 1985 to December 1988, 31 iliofemoral eversion endarterectomies were performed in 29 patients with arteriosclerosis. The surgical procedure was carried out for trophic lesions in 74% of the patients and for ischemic rest pain in the remaining 26%. In 11 operations the endarterectomy was associated with profundoplasty, and in eight with saphenous vein femoropopliteal bypass. There were six immediate failures, four of them submitted to successful reoperations, and two to above knee amputations. In cases with good immediate patency no complications occurred during the follow-up periods which ranged from one to 34 months. With one post-operative death the mortality rate was 3.2%. Two patients displayed later severe ischemic manifestations in the opposite limbs and were both submitted to the same type of operation with good result. It may be concluded that iliofemoral eversion endarterectomy is an appropriate alternative procedure to the aortoiliofemoral reconstruction surgery in patients with severe ischemia of the lower limbs.
1985年10月至1988年12月,对29例动脉硬化患者实施了31例髂股外翻内膜切除术。74%的患者因营养性病变接受手术,其余26%因静息性缺血性疼痛接受手术。11例手术中内膜切除术与股深动脉成形术联合进行,8例与大隐静脉股腘动脉旁路移植术联合进行。有6例即刻手术失败,其中4例再次手术成功,2例行膝上截肢术。在即刻通畅良好的病例中,随访期1至34个月期间未发生并发症。术后死亡1例,死亡率为3.2%。2例患者后来对侧肢体出现严重缺血表现,均接受了同类型手术,效果良好。可以得出结论,对于下肢严重缺血的患者,髂股外翻内膜切除术是主动脉髂股重建手术的一种合适替代手术。