Gulkarov Iosif, Malik Rajesh, Yakubov Rakhsim, Gagne Paul, Muhs Bart E, Rockman Caron, Cayne Neal S, Jacobowitz Glenn R, Lamparello Patrick J, Adelman Mark A, Maldonado Thomas S
Department of Surgery, New York University School of Medicine, New York 10016, USA.
Vasc Endovascular Surg. 2008;42(6):561-6. doi: 10.1177/1538574408322659. Epub 2008 Sep 10.
In patients who require lower extremity revascularization, prosthetic graft is a reasonable alternative in the absence of a suitable autologous vein conduit. However, prosthetic bypass grafts have limited patency, especially for infrageniculate reconstruction. Polytetrafluoroethylene grafts were geometrically modified at the distal end to increase their patency. The authors reviewed their experience with the Distaflo graft in patients who required lower extremity below-knee popliteal and tibial bypasses when no suitable autologous vein conduit was available. Chart review was conducted of the 57 patients who underwent 60 lower extremity bypasses over a 3-year period between June 2003 and April 2006. Twenty-four revascularizations were constructed to the tibial outflow sites, whereas the remaining grafts were placed to the below-knee (28) and above-knee (8) popliteal artery, respectively. Study endpoints were primary, assisted primary, secondary patency, and limb salvage at the time of follow-up. Distaflo bypass was performed at the infrageniculate level in 86.7% of cases (28 below-knee popliteal, 24 tibial). Mean follow-up time was 12 months (range, 0.5-37.5 months). At 1 year, primary, assisted primary, and secondary patencies and limb salvage rates for below-knee popliteal bypasses were 83.5%, 89.5%, 94.7%, and 94.4%, respectively. Primary, assisted primary, and secondary patencies and limb salvage rates for tibial bypasses were 44.4%, 44.4%, 63.2%, and 74.9%, respectively. Distaflo precuffed graft is a good alternative conduit for below-knee popliteal and tibial lower extremity reconstructions in the absence of an autologous vein and appears to have promising early patency and limb salvage rates even when used for tibial bypasses.
在需要下肢血管重建的患者中，若没有合适的自体静脉管道，人工血管是一种合理的替代选择。然而，人工血管搭桥的通畅率有限，尤其是在膝下重建时。聚四氟乙烯血管在远端进行了几何形状改良以提高其通畅率。作者回顾了他们在没有合适自体静脉管道的情况下，使用Distaflo血管对需要下肢膝下腘动脉和胫动脉搭桥的患者的治疗经验。对2003年6月至2006年4月这3年期间接受60次下肢搭桥手术的57例患者进行了病历回顾。24次血管重建是针对胫动脉流出道部位进行的，其余的血管分别放置在膝下（28例）和膝上（8例）腘动脉。研究终点是随访时的一期通畅率、辅助一期通畅率、二期通畅率和肢体挽救率。86.7%的病例（28例膝下腘动脉、24例胫动脉）在膝下水平进行了Distaflo搭桥。平均随访时间为12个月（范围0.5 - 37.
