Lensvelt M M A, Wikkeling O R M, Van Oostayen J A, Roukema J G, Zeebregts C J, Reijnen M M P J
Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
Vasc Endovascular Surg. 2012 May;46(4):338-41. doi: 10.1177/1538574412443317. Epub 2012 Apr 12.
Redo femoropopliteal bypass surgery is associated with increased morbidity and related to a poorer outcome than primary procedures. Endografts might provide an alternative, avoiding dissection of a previously operated groin. Patients treated with a polytetrafluoroethylene-covered stents for superficial femoral artery occlusive disease between February 2009 and September 2011 were prospectively gathered. Demographics, clinical status, procedural aspects, and follow-up were retrieved. Seventy-four patients were included of which 5 (7%) were treated before with a femoropopliteal bypass. Indication for intervention was Rutherford category 3 in all patients and the median ankle-brachial index (ABI) was 0.68. Technical success was achieved in all cases. The postoperative course was uneventful in all and the ABI increased to 0.95. After a follow-up period of 18 months, 4 of 5 endografts remained patent. The use of endografts after failed femoropopliteal bypass surgery is feasible and safe and could be used to avoid or minimize a difficult and hazardous dissection of a previously operated area.
再次股腘动脉搭桥手术与发病率增加相关，且与初次手术相比预后较差。腔内移植物可能提供一种替代方法，避免对先前手术过的腹股沟进行解剖。前瞻性收集了2009年2月至2011年9月期间接受聚四氟乙烯覆膜支架治疗股浅动脉闭塞性疾病的患者。收集了人口统计学、临床状况、手术相关情况及随访资料。纳入74例患者，其中5例（7%）曾接受过股腘动脉搭桥手术。所有患者的干预指征均为卢瑟福分级3级，踝肱指数（ABI）中位数为0.68。所有病例均取得技术成功。所有患者术后过程均顺利，ABI升至0.95。随访18个月后，5个腔内移植物中有4个仍保持通畅。股腘动脉搭桥手术失败后使用腔内移植物是可行且安全的，可用于避免或尽量减少对先前手术区域进行困难且危险的解剖。
