Bosiers Marc, Deloose Koen
AZ Sint-Blasius, Kroonveldlaan 50, 9200 Dendermonde, Belgium.
Catheter Cardiovasc Interv. 2009 Oct 1;74(4):627-33. doi: 10.1002/ccd.22090.
Arterial occlusive disease at the level of the femoral bifurcation mostly occurs in combination with inflow and/or outflow lesions. Surgical endarterectomy of the femoral bifurcation is a well-proven low-risk and easy surgical intervention with known durable success, while, although proven to be safe, evidence is lacking about the durability of the endovascular approach. Based on the evidence at hand, the surgical approach should be recommended for the vast majority of patients and the endovascular approach should only be indicated as the first strategy in selected cases presenting with factors that might compromise the outcome of surgery in the groin. If feasible, the hybrid approach with endarterectomy at the level of the bifurcation and endovascular repair of the inflow and outflow lesions is preferred in patients with multilevel disease.
股动脉分叉处的动脉闭塞性疾病大多与流入道和/或流出道病变合并发生。股动脉分叉处的外科内膜切除术是一种已被充分证实的低风险且简单的手术干预方法，成功率持久，而血管内介入治疗虽然已被证明是安全的，但缺乏关于其耐久性的证据。基于现有证据，对于绝大多数患者应推荐采用外科手术方法，血管内介入方法仅应作为在腹股沟区可能影响手术结果的因素的特定病例中的首选策略。如果可行，对于患有多节段疾病的患者，首选在分叉处进行内膜切除术并对流入道和流出道病变进行血管内修复的杂交手术方法。
