Taylor P R, Wolfe J H, Tyrrell M R, Mansfield A O, Nicolaides A N, Houston R E
Vascular Unit, St. Mary's Hospital and Medical School, Paddington, London, UK.
Br J Surg. 1990 Oct;77(10):1125-8. doi: 10.1002/bjs.1800771016.
In all, 412 femorodistal grafts (femoropopliteal and femorocrural), performed between 1984 and 1988, have been prospectively studied at 6 weeks and 3, 6, 9 and 12 months after operation and at intervals of 6 months thereafter by duplex scanning and intravenous digital subtraction angiography. The overall incidence of stenoses was 16 per cent (femorocrural 20 per cent, femoropopliteal 15 per cent). All stenoses were detected in the first year after operation and none occurred after this. Twenty-four non-haemodynamically significant stenoses were not treated but were followed at intervals of 3 months. Forty-two haemodynamically significant stenoses were detected and secondary procedures were performed in 30 grafts at a mean of 8 months after surgery. Thirteen had percutaneous balloon dilatation and six (46 per cent) remain patent at a mean follow-up of 22 months. Two grafts which occluded within 30 days and three which restenosed at a mean of 8 months had tertiary procedures. Seventeen grafts were surgically revised, nine with patch grafts and eight with bypass grafts. Eleven of these remain patent at a mean follow-up of 30 months. One occluded immediately and three occluded late. Two grafts which restenosed at a mean of 19 months had successful tertiary procedures. In total, seven grafts had tertiary procedures (two had balloon dilatation and five had surgery) and six of these remain patent at a mean follow-up of 13.5 months. In conclusion, 37 procedures have been performed on 30 grafts, of which 23 (77 per cent) remain patent at a mean follow-up of 12 months. Approximately one-quarter of femorodistal grafts will develop graft-related stenoses and graft surveillance is worthwhile, but only for the first year after operation.
1984年至1988年间共进行了412例股腘动脉移植术（股腘动脉和股胫动脉），术后6周、3个月、6个月、9个月和12个月以及此后每隔6个月通过双功扫描和静脉数字减影血管造影术进行前瞻性研究。狭窄的总体发生率为16%（股胫动脉20%，股腘动脉15%）。所有狭窄均在术后第一年被检测到，此后未再出现。24例血流动力学不显著的狭窄未进行治疗，但每隔3个月进行随访。检测到42例血流动力学显著的狭窄，并在术后平均8个月对30例移植血管进行了二次手术。13例接受了经皮球囊扩张术，其中6例（46%）在平均随访22个月时仍保持通畅。2例在30天内闭塞的移植血管和3例平均在8个月时再狭窄的移植血管进行了三次手术。17例移植血管进行了手术修复，9例采用补片移植，8例采用旁路移植。其中11例在平均随访30个月时仍保持通畅。1例立即闭塞，3例后期闭塞。2例平均在19个月时再狭窄的移植血管进行了成功的三次手术。总共有7例移植血管进行了三次手术（2例进行球囊扩张术，5例进行手术），其中6例在平均随访13.5个月时仍保持通畅。总之，对30例移植血管进行了37次手术，其中23例（77%）在平均随访12个月时仍保持通畅。大约四分之一的股腘动脉移植血管会出现与移植血管相关的狭窄，移植血管监测是值得的，但仅在术后第一年进行。
