West J C, Bertsch D J, Peterson S L, Gannon M P, Norkus G, Latsha R P, Kelley S E
Department of General Surgery, Gelsinger Medical Center, Danville, Pennsylvania 17822-2111.
Transplant Proc. 1991 Apr;23(2):1838-40.
Arterial insufficiency distal to an antecubital access is fortunately an infrequent but disturbing and often debilitating complication resulting in suboptimal access. During an 8 1/2-year period, 335 vascular access procedures were performed, 108 of which were antecubital brachiocephalic Gore-Tex conduits. Of these Gore-Tex conduits, 1.8% (2/108) had developed symptoms of vascular insufficiency 2 to 3 1/2 months after such access surgery. As previously published, arterial steal after the creation of an AV fistula could be corrected by the placement of an interposition Gore-Tex loop that would cure the problem and save the access. We have presented a procedure to correct a steal syndrome once a Gore-Tex conduit is already in place. Proximal banding and distal ligation with division of the cephalic vein below an end-to-side Gore-Tex loop is a simple surgical solution. It is not only curative but the procedure also maintains the existing Gore-Tex graft as a sustained avenue for access.
肘前通路远端的动脉供血不足是一种罕见但令人困扰且常导致功能衰弱的并发症，会致使通路不理想。在8年半的时间里，共进行了335例血管通路手术，其中108例是肘前肱头型戈尔泰克斯人工血管转流术。在这些戈尔泰克斯人工血管中，1.8%（2/108）在这种通路手术后2至3个半月出现了血管供血不足的症状。正如之前所发表的，动静脉内瘘形成后的动脉窃血可通过置入一段戈尔泰克斯人工血管环来纠正，这将解决问题并挽救通路。我们展示了一种在戈尔泰克斯人工血管已就位时纠正窃血综合征的方法。在端侧戈尔泰克斯人工血管环下方近端绑扎、远端结扎并切断头静脉是一种简单的手术解决方案。它不仅能治愈疾病，而且该手术还能将现有的戈尔泰克斯移植物保留为持续的通路途径。
