Multidisciplinary Endovascular Team, University College Londonand University College London Hospital, London NW12BU United Kingdom.
J Vasc Surg. 2011 Mar;53(3):867-9. doi: 10.1016/j.jvs.2010.09.071. Epub 2011 Jan 14.
Prolonged endovascular procedures requiring a large diameter sheath in each groin can be associated with significant intraoperative lower limb ischemia, particularly in those with pre-existing peripheral vascular disease. We report the case of a patient who suffered severe ischemia-reperfusion injury following endovascular repair of a pararenal aortic aneurysm using a fenestrated stent graft and describe the use of temporary axillobifemoral bypass in a patient with similar comorbidities undergoing the same procedure. We propose this adjunctive technique as a means of maintaining antegrade limb perfusion and avoiding the peripheral and central metabolic consequences of ischemia-reperfusion injury.
在每个腹股沟部位需要使用大直径鞘管的长时间血管内手术可能会导致术中下肢严重缺血，特别是对于那些已经存在外周血管疾病的患者。我们报告了一例患者在使用覆膜支架血管内修复肾周腹主动脉瘤后发生严重的缺血再灌注损伤的病例，并描述了在进行相同手术的具有类似合并症的患者中使用临时腋股旁路的情况。我们建议将这种辅助技术作为维持前向肢体灌注的手段，并避免缺血再灌注损伤的外周和中心代谢后果。
