Zou Junjie, Xia Yongxiang, Yang Hongyu, Ma Hao, Zhang Xiwei
Division of Vascular Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China.
Int Surg. 2012 Jan-Mar;97(1):56-64. doi: 10.9738/0020-8868-97.1.56.
The objective of this study was to evaluate the feasibility and efficacy of hybrid therapy (combined endarterectomy-endovascular) in patients with complex peripheral multifocal steno-obstructive vascular disease involving the femoral artery bifurcation. Forty-one combined procedures were performed on 40 patients. Although the common femoral artery was usually treated with endarterectomy, endoluminal procedures were performed proximally in 12 patients (group 1), distally in 18 patients (group 2), and both upward and downward in 11 patients (group 3). Patients underwent clinical assessment and ankle-brachial index measurement thereafter. Primary, assisted-primary, and secondary patency rates at 24 months were 59%, 66%, and 72%, respectively. Primary patency rates were lower in group 3 compared with groups 1 and 2 (P = 0.015). The limb salvage rate was 86.4% at the end of the follow-up period. Hybrid procedures provide feasible and effective treatment management of selected patients with multilevel lower extremity arterial disease involving the femoral artery bifurcation.
本研究的目的是评估杂交治疗（动脉内膜切除术-血管腔内治疗联合）对涉及股动脉分叉的复杂周围多灶性狭窄闭塞性血管疾病患者的可行性和疗效。对40例患者实施了41例联合手术。虽然股总动脉通常采用动脉内膜切除术治疗，但12例患者在近端进行了腔内手术（第1组），18例患者在远端进行了腔内手术（第2组），11例患者在上下两端都进行了腔内手术（第3组）。此后，患者接受了临床评估和踝肱指数测量。24个月时的一期通畅率、辅助一期通畅率和二期通畅率分别为59%、66%和72%。第3组的一期通畅率低于第1组和第2组（P = 0.015）。随访期末的肢体挽救率为86.4%。杂交手术为选定的涉及股动脉分叉的多节段下肢动脉疾病患者提供了可行且有效的治疗管理。
