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保肢手术中的旁路移植术:聚四氟乙烯人工血管旁路移植术

Bypass surgery in limb salvage: polytetrafluoroethylene prosthetic bypass.

作者信息

Naoum Joseph J, Arbid Elias J

机构信息

The Methodist Hospital, Houston, Texas, USA.

出版信息

Methodist Debakey Cardiovasc J. 2012 Oct-Dec;8(4):43-6. doi: 10.14797/mdcj-8-4-43.

DOI:10.14797/mdcj-8-4-43
PMID:23342188
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3549650/
Abstract

Polytetrafluoroethylene (PTFE) grafts have proven to be an adequate alternative conduit for peripheral bypass operations. Whether or not one uses PTFE depends on several factors: surgeon preference, individual patient circumstances, or when autologous greater saphenous vein is not available or adequate. These conventional grafts have evolved and undergone modification. The intraluminal surface has been coated with carbon or bonded with heparin. The structure of grafts has been modified with the creation of a hood or cuff, with the incorporation of a stent-graft segment for a sutureless anastomosis, or the fusion of PTFE with an outer polyester layer to minimize suture hole bleeding. This evolution intends to limit graft thrombogenicity, ameliorate the formation of intimal hyperplasia, decrease complications, and improve overall graft patency.

摘要

聚四氟乙烯(PTFE)移植物已被证明是外周旁路手术中一种合适的替代管道。是否使用PTFE取决于几个因素:外科医生的偏好、患者的个体情况,或者自体大隐静脉不可用或不合适时。这些传统移植物已经得到改进并经历了改良。管腔内表面已涂覆碳或与肝素结合。移植物的结构已通过以下方式进行改良:创建一个罩或袖口,并入一个用于无缝合吻合的支架移植物段,或将PTFE与外部聚酯层融合以尽量减少缝合孔出血。这种改进旨在限制移植物的血栓形成性,改善内膜增生的形成,减少并发症,并提高移植物的总体通畅率。

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本文引用的文献

1
ViPS (Viabahn Padova Sutureless) technique: preliminary results in the treatment of peripheral arterial disease.ViPS(维亚巴恩帕多瓦无缝合)技术:治疗外周动脉疾病的初步结果。
Ann Vasc Surg. 2012 Jan;26(1):34-9. doi: 10.1016/j.avsg.2011.07.003. Epub 2011 Oct 22.
2
A multicenter comparison between autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene (ePTFE) graft in the treatment of critical limb ischemia in diabetics.自体大隐静脉与肝素结合膨体聚四氟乙烯(ePTFE)移植物治疗糖尿病患者肢体严重缺血的多中心比较。
J Vasc Surg. 2011 Nov;54(5):1332-8. doi: 10.1016/j.jvs.2011.05.046. Epub 2011 Aug 15.
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Midterm results of autologous saphenous vein and ePTFE pre-cuffed bypass surgery in peripheral arterial occlusive disease.自体大隐静脉和预袖套式ePTFE在外周动脉闭塞性疾病中的搭桥手术中期结果
Vasc Endovascular Surg. 2011 Oct;45(7):598-603. doi: 10.1177/1538574411414923. Epub 2011 Jul 14.
4
The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial.斯堪的纳维亚普洛潘特(®)试验——肝素涂覆内腔表面的膨体聚四氟乙烯血管移植物与普通纯膨体聚四氟乙烯血管移植物 1 年通畅率的比较——一项随机临床对照多中心试验。
Eur J Vasc Endovasc Surg. 2011 May;41(5):668-73. doi: 10.1016/j.ejvs.2011.01.021. Epub 2011 Mar 3.
5
Heparin-bonded ePTFE grafts compared with vein grafts in femoropopliteal and femorocrural bypasses: 1- and 2-year results.肝素结合的膨体聚四氟乙烯移植物与静脉移植物用于股腘和股小腿旁路移植术的比较:1年和2年结果
J Vasc Surg. 2009 May;49(5):1210-6. doi: 10.1016/j.jvs.2008.12.009.
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Heparin-induced thrombocytopenia after implantation of a heparin-bonded polytetrafluoroethylene lower extremity bypass graft: A case report and plan for management.肝素结合聚四氟乙烯下肢旁路移植术后肝素诱导的血小板减少症:一例报告及处理方案
J Vasc Surg. 2009 Apr;49(4):1037-40. doi: 10.1016/j.jvs.2008.12.004.
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Early results for below-knee bypasses using Distaflo.使用Distaflo进行膝下旁路手术的早期结果。
Vasc Endovascular Surg. 2008;42(6):561-6. doi: 10.1177/1538574408322659. Epub 2008 Sep 10.
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A heparin-bonded vascular graft generates no systemic effect on markers of hemostasis activation or detectable heparin-induced thrombocytopenia-associated antibodies in humans.肝素结合血管移植物对人体止血激活标志物或可检测到的肝素诱导的血小板减少相关抗体无全身影响。
J Vasc Surg. 2008 Feb;47(2):324-9; discussion 329. doi: 10.1016/j.jvs.2007.10.005.
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Risk of heparin-induced thrombocytopenia from heparin-bonded vascular prostheses.肝素结合型血管假体导致肝素诱导的血小板减少症的风险。
Ann Vasc Surg. 2007 Nov;21(6):719-22. doi: 10.1016/j.avsg.2007.07.016.
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Comparison of carbon-impregnated and standard ePTFE prostheses in extra-anatomical anterior tibial artery bypass: a prospective randomized multicenter study.
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