Blanshard K S, Hacking P M
Department of Radiology, Royal Victoria Infirmary, Newcastle Upon Tyne.
Clin Radiol. 1990 Oct;42(4):269-73. doi: 10.1016/s0009-9260(05)82116-6.
The results of infra-inguinal graft fibrinolysis are variable, and the true success rates are frequently disguised by the inclusion of patients receiving adjunctive surgery, such as surgical thrombectomy, anastomosis revision and graft extension. Follow-up is sparse. As part of a larger prospective study, we have offered fibrinolysis using streptokinase to 10 patients with occluded infra-inguinal synthetic grafts. In one patient the graft could not be entered with a catheter. The remaining nine patients received local low-dose intra-arterial streptokinase. Six patients experienced complete lysis and were discharged with functioning grafts. Significant stenoses were dilated by transluminal angioplasty. The median graft patency duration was 7 months. Two patients have since required above-knee amputations. Our results using transluminal angioplasty are comparable to those results where adjunctive surgery has been used to treat underlying anastomotic stenoses. Further research into graft anastomotic stenosis management is indicated.
腹股沟下移植血管纤溶的结果各异，而且真正的成功率常常因纳入了接受辅助手术（如外科血栓切除术、吻合口修复和移植血管延长术）的患者而被掩盖。随访资料匮乏。作为一项更大规模前瞻性研究的一部分，我们对10例腹股沟下人工血管闭塞患者采用链激酶进行纤溶治疗。1例患者的移植血管无法通过导管进入。其余9例患者接受了局部低剂量动脉内链激酶治疗。6例患者实现了完全溶解，带功能良好的移植血管出院。通过腔内血管成形术扩张了显著狭窄处。移植血管通畅的中位持续时间为7个月。此后有2例患者需要进行膝上截肢。我们采用腔内血管成形术的结果与使用辅助手术治疗潜在吻合口狭窄的结果相当。有必要对移植血管吻合口狭窄的处理进行进一步研究。
