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血管腔内治疗时代外周动脉疾病的外科治疗作用

Role of surgical treatment for peripheral arterial disease in endovascular era.

作者信息

Park Sang Jun, Hwang Jae Chol, Cho Hong Rae, Park Ho Jong, Kim Sang Jin, Park Bong Won

机构信息

Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

出版信息

J Korean Surg Soc. 2013 Jun;84(6):353-9. doi: 10.4174/jkss.2013.84.6.353. Epub 2013 May 28.

Abstract

PURPOSE

The purpose of this study is to review the roll changes of surgical treatment for peripheral artery disease in endovascular era.

METHODS

One hundred and twelve surgically treated cases of peripheral artery disease at a single institution during the period from 2006 to 2011 were studied retrospectively. The cases were divided into two groups of different time periods, one before 2009 (surgical period group) and the other from 2009 onward (endovascular period group). We analyzed the type and location of surgery as well as clinical characteristics of patients and treatment results.

RESULTS

Fifty-three cases were for the surgical period group and 59 cases for the endovascular group. No difference in the demographic characteristics and the distribution of major atherosclerosis risk factors was found between the two groups. Additionally, the technical and functional success rate was similar in both groups. However, it is found that there were more acute cases in the endovascular period group than in the surgical period group. The number of cases in need of suprainguinal or below knee exposure was similar in both groups. In hybrid cases, suprainguinal or below knee exposures were more frequently needed during the former period than the latter period.

CONCLUSION

The role of surgical treatment is currently in the process of changing. Surgical treatment seems to be a complementary alternative to endovascular treatment for chronic limb ischemia. However, it still seems to play a major role for acute limb ischemia.

摘要

目的

本研究旨在回顾血管腔内治疗时代外周动脉疾病外科治疗的作用变化。

方法

回顾性研究了2006年至2011年期间在单一机构接受外科治疗的112例外周动脉疾病患者。这些病例被分为两个不同时间段的组,一组为2009年之前(手术期组),另一组为2009年及以后(血管腔内治疗期组)。我们分析了手术类型、部位以及患者的临床特征和治疗结果。

结果

手术期组有53例,血管腔内治疗期组有59例。两组在人口统计学特征和主要动脉粥样硬化危险因素分布方面无差异。此外,两组的技术成功率和功能成功率相似。然而,发现血管腔内治疗期组的急性病例比手术期组更多。两组中需要腹股沟上或膝下暴露的病例数相似。在杂交病例中,前期比后期更频繁地需要腹股沟上或膝下暴露。

结论

目前外科治疗的作用正在发生变化。对于慢性肢体缺血,外科治疗似乎是血管腔内治疗的一种补充替代方法。然而,对于急性肢体缺血,它似乎仍起着主要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b6d/3671004/45fdc0a55d46/jkss-84-353-g001.jpg

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