Department of General, Thoracic and Vascular Surgery, Bonn, Germany.
Br J Surg. 2010 Mar;97(3):344-8. doi: 10.1002/bjs.6876.
The aim of this study was to compare preoperative and postoperative findings, and clinical progress in patients with peripheral arterial occlusive disease undergoing femoropopliteal supragenicular bypass or profundaplasty in a case-control study.
Between January 2001 and June 2004, 171 patients with occlusion of the superficial femoral artery underwent surgery. A retrospective analysis of 28 matched patient pairs was performed. Endpoints were bypass occlusion, surgical revision, amputation and death. Mean length of follow-up was 36 months.
At 3 years after surgery there was no statistically significant difference in outcome between femoropopliteal bypass surgery and profundaplasty. There was a trend towards improved results in patients who had bypass surgery for critical leg ischaemia. Preoperative patency of the crural outflow arteries was an independent prognostic factor in multivariable analysis.
There were no significant outcome differences between supragenicular bypass surgery or profundaplasty in patients who had surgery for intermittent claudication or ischaemic rest pain. Patients with a single patent tibial artery and gangrene or ulceration appeared to benefit more from bypass surgery.
本研究旨在通过病例对照研究比较行股腘动脉膝上旁路术或膝下内膜切除术的下肢动脉闭塞性疾病患者的术前和术后发现及临床进展。
2001 年 1 月至 2004 年 6 月,171 例股浅动脉闭塞患者接受了手术治疗。对 28 对匹配的患者进行了回顾性分析。终点为旁路闭塞、手术修正、截肢和死亡。平均随访时间为 36 个月。
术后 3 年,股腘旁路手术与膝下内膜切除术的结果无统计学差异。对于有严重肢体缺血的患者,旁路手术的结果有改善趋势。小腿流出动脉的术前通畅性是多变量分析中的独立预后因素。
对于间歇性跛行或缺血性静息痛患者,膝上旁路手术或膝下内膜切除术的结果无显著差异。对于仅有单一通畅的胫动脉和伴有坏疽或溃疡的患者,旁路手术似乎更有益。