Zempo N, Yoshimura K, Akimoto F, Nakamura T, Ohara M, Wakamatsu T, Esato K
First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Nihon Geka Gakkai Zasshi. 1991 Aug;92(8):1010-5.
The purpose of this study was to determine the operative indication for patients with intermittent claudication because of arteriosclerosis obliterans, and to compare the late result of the surgical treatment group (130 cases, 175 limbs) with that of the non-surgical treatment group (27 cases, 31 limbs). There were 3 operative deaths and 21 late deaths in the surgical group, and 11 late deaths in the non-surgical group. The number one cause of death was heart failure, including ischemic heart disease, in both groups. The 5-year cumulative patency rate was 92.5% in the aorto-iliac, 70.6% in the femoro-distal and 82.0% in the aorto-femoro-distal arterial reconstructions. Long term symptom free rates of the surgical group and the non-surgical group, except fatal cases, were 87.2% and 25.0% in the aorto-iliac, 57.7% and 25.0% in the femoro-distal, 86.7% and 0% in the aorto-femoro-distal arterial regions, respectively. Late result of intermittent claudication in the surgical group was better than that in the non-surgical group. We conclude that intermittent claudication should be considered to be the indication for surgery, except for the cases with high risk diseases or malignant diseases.
本研究的目的是确定因动脉硬化闭塞症导致间歇性跛行患者的手术适应症，并比较手术治疗组（130例，175条肢体）和非手术治疗组（27例，31条肢体）的远期结果。手术组有3例手术死亡和21例晚期死亡，非手术组有11例晚期死亡。两组的首要死因均为心力衰竭，包括缺血性心脏病。主动脉-髂动脉重建的5年累积通畅率为92.5%，股-远端动脉重建为70.6%，主动脉-股动脉重建为82.0%。手术组和非手术组（除致命病例外）在主动脉-髂动脉区域的长期无症状率分别为87.2%和25.0%，在股-远端动脉区域分别为57.7%和25.0%，在主动脉-股动脉区域分别为86.7%和0%。手术组间歇性跛行的远期结果优于非手术组。我们得出结论，除患有高危疾病或恶性疾病的病例外，间歇性跛行应被视为手术适应症。
