Bakoyiannis C N, Tsekouras N, Matthaiou A, Georgopoulos S E, Economopoulos K P, Tsigris C, Bastounis E
First Department of Surgery, University of Athens Medical School, Laiko General Hospital, Athens, Greece.
Int Angiol. 2009 Oct;28(5):380-4.
The aim of this paper was to describe a new modification of the remote endarterectomy for the treatment of long superficial femoral artery (SFA) occlusions and to present our preliminary results. Through a subinguinal incision and arteriotomy over the SFA origin, a hydrophilic guidewire was introduced into the subintimal plane of the SFA and advanced distally until reentry into the distal patent popliteal artery. The hydrophilic guidewire is exchanged for an Ablatz wire to provide support for the advancement of the single endarterectomy ring. The MollRing Cutter was introduced in the SFA after the removal of the single endarterectomy ring and it was advanced until the re-entry point. The atherosclerotic core was removed and a nitinol self-expanding stent was placed at the peripheral end of the endarterectomy. Arteriotomy was closed with a patch. Guided subintimally-assisted remote endarterectomy seems to be a successful and safe modification of the traditional technique in the treatment of SFA occlusion, in patients with critical limb ischemia.
本文的目的是描述一种用于治疗股浅动脉（SFA）长段闭塞的远端动脉内膜切除术的新改良方法，并展示我们的初步结果。通过腹股沟下切口及在SFA起始处进行动脉切开，将一根亲水导丝引入SFA的内膜下平面并向远端推进，直至重新进入远端通畅的腘动脉。将亲水导丝换成Ablatz导丝，为单环动脉内膜切除术环的推进提供支撑。在移除单环动脉内膜切除术环后，将MollRing切割器引入SFA并推进至重新进入点。清除动脉粥样硬化核心，并在动脉内膜切除术的外周端置入一枚镍钛诺自膨式支架。动脉切开处用补片封闭。在治疗严重肢体缺血患者的SFA闭塞时，内膜下引导辅助远端动脉内膜切除术似乎是传统技术的一种成功且安全的改良方法。
