Hussein E A, Al-Kreedees A, Saad A, Wahba T, Al-Shamimi S
Department of Surgery, Vascular Surgery Unit, King Faisal University, King Fahd Hospital of the University, Al Khobar, Kingdom of Saudi Arabia.
Int Angiol. 2010 Dec;29(6):565-9.
A male patient who sustained a blunt trauma to the right knee and chest resulting in posterior dislocation of the knee joint and avulsion injury to the right popliteal artery (segments II and III) had a vascular repair by interposition saphenous vein graft. Postoperatively an episode of hypotension resulted in thrombotic occlusion of the graft and acute limb ischemia. Graft and distal thrombectomy, though successful, resulted in a stenotic segment with two perforations. To shorten the operating time this was managed by Viabahn Endoprothesis stent-graft through both native popliteal artery and vein graft. Immediate regain of pedal pulses was achieved, and at 6 months follow up Viabahn endograft is still patent, foot well perfused with normal pedal pulses and patient fully active. In complicated popliteal artery injuries, with complex time consuming revascularization procedures, an endovascular graft as a back up or bail-out technique might be a valid option in some selected cases with high anesthetic risk, to shorten operating time. In this context Viabahn endoprosthesis seems to be both efficient and durable on the short term.
一名男性患者右膝和胸部遭受钝器伤，导致膝关节后脱位以及右腘动脉（II和III段）撕脱伤，通过大隐静脉移植进行了血管修复。术后一次低血压发作导致移植血管血栓形成闭塞以及急性肢体缺血。尽管移植血管和远端血栓切除术成功，但形成了一个有两个穿孔的狭窄段。为缩短手术时间，通过在自体腘动脉和移植静脉中置入Viabahn腔内血管修复支架移植物来处理。即刻恢复了足背动脉搏动，在6个月随访时，Viabahn腔内移植物仍然通畅，足部血供良好，足背动脉搏动正常，患者活动完全正常。在复杂的腘动脉损伤以及复杂且耗时的血管重建手术中，对于某些麻醉风险高的特定病例，血管腔内移植物作为一种备用或补救技术，可能是缩短手术时间的有效选择。在这种情况下，Viabahn腔内血管修复支架移植物在短期内似乎既有效又耐用。
