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2
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3
Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: Analysis of amputation free and overall survival by treatment received.BASIL 试验：下肢严重缺血患者旁路与血管成形术的比较：按治疗方法分析免于截肢和总生存率。
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4
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J Vasc Surg. 2010 May;51(5 Suppl):5S-17S. doi: 10.1016/j.jvs.2010.01.073.
5
Combined infrainguinal reconstruction and infrapopliteal intraluminal angioplasty for limb salvage in critical limb ischemia.联合腹股沟下重建术与腘下腔内血管成形术治疗严重肢体缺血以挽救肢体
Interact Cardiovasc Thorac Surg. 2009 Aug;9(2):191-4. doi: 10.1510/icvts.2009.204867. Epub 2009 May 26.
6
Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II).外周动脉疾病管理跨学会共识（TASC II）
J Vasc Surg. 2007 Jan;45 Suppl S:S5-67. doi: 10.1016/j.jvs.2006.12.037.
7
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8
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9
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One hundred twenty-five concomitant endovascular and open procedures for lower extremity arterial disease.针对下肢动脉疾病的125例血管内与开放手术联合治疗。
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联合主-髂动脉和股腘动脉重建术治疗严重肢体缺血的长期结果

Long-term results of combined aortoiliac and infrainguinal arterial reconstruction for the treatment of critical limb ischemia.

作者信息

Miyahara Takuya, Shigematsu Kunihiro, Nishiyama Ayako, Hashimoto Takuya, Hoshina Katsuyuki, Watanabe Toshiaki

机构信息

Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan.

出版信息

Ann Vasc Dis. 2015;8(1):14-20. doi: 10.3400/avd.oa.14-00119. Epub 2015 Feb 16.

DOI:10.3400/avd.oa.14-00119
PMID:25848426
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4369561/
Abstract

OBJECTIVE

This study was designed to investigate our long-term experience with combined iliac endovascular therapy (EVT) and infrainguinal bypass to treat critical limb ischemia (CLI) and compare outcomes to those of patients who underwent surgery for aortoiliac lesions.

MATERIALS AND METHODS

From April 2000 to June 2013, 57 patients (58 limbs) underwent an infrainguinal bypass combined with aortoiliac reconstruction to treat CLI. Eighteen limbs were treated by bypass alone and 8 limbs were treated by bypass with EVT for aortoiliac lesions (Bypass group). Thirty-two limbs were subjected to EVT alone for iliac lesions (EVT group).

RESULTS

Preoperative limb ischemia was more severe in the EVT group. There were no significant differences in major procedure-related complications (χ(2) test, P = 0.853), systemic complications (P = 0.853), and mortality (P = 0.916) between the 2 groups. The limb salvage rates were 92% at 1, 3, and 5 years in the Bypass group and 93% at 1, 3, and 5 years in the EVT group, with no significant difference observed between the groups (Kaplan-Meier, log-rank test, P = 0.616).

CONCLUSION

Infrainguinal surgical reconstruction combined with an iliac EVT is an acceptable strategy for managing patients with CLI.

摘要

目的

本研究旨在探讨我们采用髂血管腔内治疗（EVT）联合股腘动脉旁路移植术治疗严重肢体缺血（CLI）的长期经验，并将结果与接受主髂动脉病变手术的患者进行比较。

材料与方法

2000年4月至2013年6月，57例患者（58条肢体）接受了股腘动脉旁路移植术联合主髂动脉重建术以治疗CLI。18条肢体仅接受旁路移植术治疗，8条肢体接受旁路移植术联合主髂动脉病变的EVT治疗（旁路移植组）。32条肢体仅接受髂动脉病变的EVT治疗（EVT组）。

结果

EVT组术前肢体缺血更严重。两组在主要手术相关并发症（χ²检验，P = 0.853）、全身并发症（P = 0.853）和死亡率（P = 0.916）方面无显著差异。旁路移植组1年、3年和5年的肢体挽救率分别为92%，EVT组为93%，两组间无显著差异（Kaplan-Meier法，对数秩检验，P = 0.616）。

结论

股腘动脉手术重建联合髂动脉EVT是治疗CLI患者的一种可接受的策略。