Haiat R, Dahan D, Kun P, Chiche P, Flabeau F
Sem Hop. 1976 Nov 16;52(39):2209-13.
The authors report 26 cases (average age 69 years) of stage IV atheroma of the leg arteries for which a conservative surgical operation was attempted. Aortography (18 times) or femoral arteriography (8 times) were performed without difficulty before operation. During the same operation, a single procedure was performed in 15 cases, 2 or 3 procedures were performed in 11 cases. Thus were carried out: sympathectomy in 7 cases, endarterectomy in 8 cases, a by-pass operation in 23 cases. There were 4 deaths (15%) during the postoperative period. In 18 of the 22 patients who survived the operation, trophic disorders completely disappeared, and the functional result assessed with an average follow up of 15 months (1 to 25 months) on the degree of intermitent claudication was judged good or very good in 16 cases, mediocre in 2 cases. In 4 of these 22 patients, the trophic disorders persisted or reappeared in the short term and amputation was then carried out in 3 of these 4 cases. Conservative surgery remains possible and useful in stage IV arterial disease of the lower limbs. It is however important to operate early in the course of the disease after failure of adequate medical treatment.
作者报告了26例（平均年龄69岁）下肢动脉IV期动脉粥样硬化病例，对其尝试进行了保守性外科手术。术前顺利进行了18次主动脉造影或8次股动脉造影。在同一手术中，15例进行了单一手术操作，11例进行了2次或3次手术操作。具体实施情况如下：7例进行了交感神经切除术，8例进行了动脉内膜切除术，23例进行了旁路手术。术后有4例死亡（15%）。在手术存活的22例患者中，18例的营养障碍完全消失，对其中16例平均随访15个月（1至25个月），根据间歇性跛行程度评估功能结果为良好或非常好，2例为中等。在这22例患者中的4例，营养障碍在短期内持续存在或复发，其中4例中的3例随后进行了截肢。保守性手术在下肢动脉疾病IV期仍然可行且有用。然而，在充分药物治疗失败后，尽早在疾病过程中进行手术很重要。
