Beno M, Rumenapf G
Diakonissenstiftungs KKH Speyer, Klinik für Gefässchirurgie, Speyer, Germany.
Bratisl Lek Listy. 2010;111(2):83-9.
Authors retrospectively analyze a group of patients with symptomatic peripheral arterial occlusive disease (PAOD) who underwent an arterial reconstruction with a remote retrograde endarterectomy combined with intraoperative angiography and endovascular techniques as a hybrid procedure.
During the year 2007, there were 83 patients with PAOD planned for the remote retrograde endarterectomy of the iliofemoral arteries. Due to perioperative findings or complications, in 11 cases (13.25%) an alternative vascular procedure was necessary. In 52 (62.65%) patients the remote endarterectomy of iliofemoral arteries was performed separately or in connection with the endarterectomy of femoral bifurcation or bypass. In 20 (24.1%) patients, the remote endarterectomy was performed as a part of hybrid procedure. A technical success was achieved in 72 (from 83 patients - 86.7%) and a clinical success in 71 (from 72 patients - 98.6%) patients in whom a successful remote retrograde endarterecomy was performed. There were 15 operations needed in the postoperative period, but only two of them were necessary because of close relation with an unfavorable outcome after the remote endarterectomy. No perioperative and postoperative mortality was observed in the whole group of patients. During the follow up in the next 6 months, patency was proved in all patients after a successful remote endarterectomy.
Endovascular techniques in vascular surgery, remote endarterectomy is in our opinion a safe and durable method in the therapy of selected patients with PAOD (Tab. 4, Fig. 3, Ref. 8). Full Text (Free, PDF) www.bmj.sk.
作者回顾性分析一组有症状的外周动脉闭塞性疾病(PAOD)患者,这些患者接受了一种混合手术,即采用远端逆行内膜切除术联合术中血管造影和血管内技术进行动脉重建。
2007年期间,有83例PAOD患者计划接受髂股动脉远端逆行内膜切除术。由于围手术期的发现或并发症,11例(13.25%)患者需要进行替代血管手术。52例(62.65%)患者单独进行了髂股动脉远端内膜切除术,或与股动脉分叉内膜切除术或旁路手术联合进行。20例(24.1%)患者将远端内膜切除术作为混合手术的一部分。在成功进行远端逆行内膜切除术的72例(83例患者中的 - 86.7%)患者中技术成功,在71例(72例患者中的 - 98.6%)患者中临床成功。术后需要进行15次手术,但其中只有两次是由于与远端内膜切除术后不良结局密切相关而必要的。在整个患者组中未观察到围手术期和术后死亡。在接下来的6个月随访期间,所有成功进行远端内膜切除术的患者均证明血管通畅。
在血管外科的血管内技术中,远端内膜切除术在我们看来是治疗选定PAOD患者的一种安全且持久的方法(表4,图3,参考文献8)。全文(免费,PDF)www.bmj.sk 。