Cavallaro Antonio, Sterpetti Antonio V, Sapienza Paolo, Dimarzo Luca
I Isituto Clinica Chirurgica, Università di Roma La Sapienza, Roma, Italia.
Ann Vasc Surg. 2012 Apr;26(3):383-6. doi: 10.1016/j.avsg.2011.06.020. Epub 2012 Jan 27.
The aim of the study was to describe and analyze the results of a technique in which the inflow for distal bypasses is provided by the proximal superficial femoral artery, reopened through an eversion endarterectomy, to avoid a "difficult groin."
Twenty-one patients who underwent distal bypass for severe lower-limb ischemia and in whom the proximal superficial femoral artery was reopened with an eversion endarterectomy to provide inflow for the bypass itself were included in the study. As a comparison group, 20 patients in whom the inflow for a distal bypass was obtained by the distal deep femoral artery were randomly selected. In all 41 patients, the groin was considered "difficult" because of multiple previous operations.
Five-year cumulative patency rates were 53% for femoropopliteal bypasses and 40% for femorotibial bypasses. Similar patency rates were obtained when the distal deep femoral artery was used as inflow.
Eversion endarterectomy of the proximal superficial femoral artery provides a valid source of inflow for distal bypasses, and it should be kept in the armamentarium of the vascular surgeon, to be used in selected cases.
本研究的目的是描述和分析一种技术的结果，该技术通过外翻内膜切除术重新开通近端股浅动脉，为远端旁路手术提供血流，以避免出现“困难腹股沟”情况。
本研究纳入了21例行远端旁路手术治疗严重下肢缺血且通过外翻内膜切除术重新开通近端股浅动脉以为旁路手术本身提供血流的患者。作为对照组，随机选取了20例通过股深动脉远端为远端旁路手术获取血流的患者。在所有41例患者中，由于既往多次手术，腹股沟被认为是“困难的”。
股腘动脉旁路手术的5年累积通畅率为53%，股胫动脉旁路手术的5年累积通畅率为40%。当使用股深动脉远端作为血流来源时，获得了相似的通畅率。
近端股浅动脉外翻内膜切除术为远端旁路手术提供了有效的血流来源，应保留在血管外科医生的技术储备中，用于特定病例。
