Dorweiler Bernhard, Friess Tanja, Duenschede Friedrich, Doemland Marco, Espinola-Klein Christine, Vahl Christian-Friedrich
Division of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, Johannes-Gutenberg University, Mainz, Germany.
Division of Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, Johannes-Gutenberg University, Mainz, Germany.
Ann Vasc Surg. 2014 Apr;28(3):633-9. doi: 10.1016/j.avsg.2013.04.026. Epub 2013 Dec 17.
The purpose of this study was to analyze the long-term results of infrainguinal bypass surgery using the deep femoral artery (DFA) as the inflow source.
Between 1998 and 2011, 88 bypasses of the lower limb were placed in 86 patients (mean age 71 years) using the deep femoral artery as inflow. Patients' records were retrieved from a computerized database and analyzed retrospectively.
Critical limb ischemia (rest pain/tissue loss) was the indication in the majority (87.5%) of cases. The distal anastomosis of the bypass grafts was located at the popliteal level in 32 cases and the tibial (pedal) level in 52 cases, respectively, with the autologous vein as conduit in 94% of cases. Perioperative mortality was 2.3% and 77 patients (79 limbs) were followed over a mean period of 48 months. Overall primary, primary assisted, and secondary patency rates of 64.2%, 74.9%, and 92.3% were noted at 60 months, respectively. The limb salvage rate was 97%, with an overall survival of 48.7% at 60 months.
The deep femoral artery can serve as reliable inflow source for infrainguinal bypass surgery in difficult situations like redo groin surgery, limited conduit length, and circumferential nonobstructive calcification of the common femoral artery.
本研究旨在分析以股深动脉（DFA）作为流入源的股下旁路手术的长期结果。
1998年至2011年期间，对86例患者（平均年龄71岁）进行了88例下肢旁路手术，以股深动脉作为流入源。从计算机化数据库中检索患者记录并进行回顾性分析。
大多数病例（87.5%）的手术指征为严重肢体缺血（静息痛/组织缺失）。旁路移植物的远端吻合分别位于腘动脉水平32例，胫（足）动脉水平52例，94%的病例使用自体静脉作为管道。围手术期死亡率为2.3%，77例患者（79条肢体）平均随访48个月。60个月时，总体一期通畅率、一期辅助通畅率和二期通畅率分别为64.2%、74.9%和92.3%。肢体挽救率为97%，60个月时总体生存率为48.7%。
在诸如再次腹股沟手术、管道长度受限和股总动脉周向无阻塞性钙化等困难情况下，股深动脉可作为股下旁路手术可靠的流入源。
