Ozbek Cengiz, Kestelli Mert, Bozok Sahin, Ilhan Gokhan, Yurekli Ismail, Ozpak Berkan, Akyuz Muhammet, Bademci Mehmet
Department of Cardiovascular Surgery, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
Asian Cardiovasc Thorac Ann. 2014 Jan;22(1):36-9. doi: 10.1177/0218492312468285. Epub 2013 Jul 11.
The results of surgical approaches are unsatisfactory in patients with a distal arterial bed that is ineligible for revascularization. In this retrospective study, we investigated outcomes in patients who underwent surgical interventions that are reported to induce angiogenesis.
6 patients diagnosed with thromboangiitis obliterans were included in this study. Of these 6 patients, 2 underwent femoropopliteal bypass surgery using reversed great saphenous vein as a conduit. The other 4 underwent ascending venous arterialization (bypass from the popliteal artery to the great saphenous vein at the level of medial malleolus, using reversed great saphenous vein).
During the early postoperative period, all of the reversed saphenous vein grafts were occluded. The mean postoperative ankle-brachial index increased from 0.33 to 0.83. During the postoperative period, intermittent claudication disappeared in all patients. Angiograms taken during the postoperative period showed evidence of neovascularization when compared to those taken during preoperative evaluation.
Wound healing is an inflammatory process that simultaneously activates angiogenesis. We propose that the improved ankle-brachial index values and neovascularization shown in our patients were associated with this inflammatory process.
对于远端动脉床不适合血管重建的患者，手术治疗方法的效果并不理想。在这项回顾性研究中，我们调查了接受据报道可诱导血管生成的手术干预的患者的预后情况。
本研究纳入了6例诊断为血栓闭塞性脉管炎的患者。在这6例患者中，2例采用大隐静脉倒置作为管道进行股腘动脉搭桥手术。另外4例接受了升静脉动脉化手术（在踝部内侧水平从腘动脉到大隐静脉进行搭桥，使用大隐静脉倒置）。
术后早期，所有大隐静脉倒置移植物均发生闭塞。术后踝肱指数平均从0.33升至0.83。术后期间，所有患者的间歇性跛行均消失。与术前评估时拍摄的血管造影相比，术后拍摄的血管造影显示有新生血管形成的证据。
伤口愈合是一个同时激活血管生成的炎症过程。我们认为，我们患者中显示的踝肱指数值改善和新生血管形成与这一炎症过程有关。
