Bartos J, Mayzlík J, Puchmayer V, Skotnicová S, Michalský R, Docekal B
Surgical Clinic, Institute of Medical and Pharmaceutical Education, Ostrava, Czechoslovakia.
Int Angiol. 1991 Jan-Mar;10(1):25-8.
There are different opinions about the usefulness of preoperative arteriography. Therefore we resolved to show its importance for the distal runoff evaluation as well as for the indication and results of femoropopliteal vein bypasses. There were controlled 149 patients 1-5 years after femoropopliteal vein bypass implantations. Seventy six vein bypasses proved to be patent and seventy three were closed. The findings of preoperative arteriographies visualizating the whole arterial periphery, including the pedal arch arteries, were compared in both groups of patients. It was proved that the evaluation of the distal runoff by means of preoperative arteriography may be reliable and correct under condition of tibial and pedal arch arteries visualization. According to our experience, the preoperative arteriography can be performed in such a way to fulfil this indispensable condition. In rare case of preoperative arteriography repeated failure, it is the peroperative prebypass arteriography, which always is successful. In evaluating the distal runoff, there must be taken into consideration the whole arterial complex: tibial + pedal arch arteries. The patency of pedal arch seems to be more important than the number of patent tibial arteries. According to preoperative arteriographic findings, there is possible to distinguish three main types of distal runoff: (1) Sufficient runoff: whole pedal arch and 1-3 tibial arteries patent; (2) satisfactory runoff: partial pedal arch patency and 1-3 tibial arteries patent; (3) Unsufficient runoff: total pedal arch obliterations and 1-3 tibial arteries patency.
关于术前动脉造影的作用存在不同观点。因此，我们决定展示其在评估远端血流以及股腘静脉搭桥术的适应症和结果方面的重要性。对149例患者在股腘静脉搭桥植入术后1至5年进行了对照研究。76例静脉搭桥显示通畅，73例闭塞。对两组患者术前动脉造影显示包括足弓动脉在内的整个动脉周边情况的结果进行了比较。结果证明，在胫动脉和足弓动脉显影的情况下，通过术前动脉造影评估远端血流可能是可靠且正确的。根据我们的经验，术前动脉造影可以以满足这一必要条件的方式进行。在术前动脉造影罕见的重复失败情况下，术中搭桥前动脉造影总是成功的。在评估远端血流时，必须考虑整个动脉复合体：胫动脉+足弓动脉。足弓的通畅似乎比通畅的胫动脉数量更重要。根据术前动脉造影结果，可以区分出三种主要的远端血流类型：（1）充足的血流：整个足弓和1至3条胫动脉通畅；（2）满意的血流：部分足弓通畅且1至3条胫动脉通畅；（3）不充足的血流：整个足弓闭塞且1至3条胫动脉通畅。
