Yanagiuchi T, Kimura M, Shiraishi J, Sawada T
Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
EJVES Short Rep. 2016 Mar 8;30:16-19. doi: 10.1016/j.ejvssr.2016.02.001. eCollection 2016.
For patients with infra-inguinal autologous vein bypass graft occlusion, conventional open surgical repair or endovascular treatment (EVT) for native vessel occlusion have generally been performed.
A 73 year old female with non-healing ulcer and gangrene of the left lower leg was diagnosed as having infra-inguinal autologous saphenous vein graft occlusion. In this case, surgical repair such as patch angioplasty, interposition graft, or replacement graft did not seem promising because of repeated previous infection in the polytetrafluoroethylene (PTFE) vascular prosthesis and absence of available autologous vein due to past surgery. Moreover, there was no chance of crossing the native vessel, since the proximal superficial femoral artery (SFA) had already been resected. Thus, EVT was performed for the occluded autologous vein graft, implanting multiple self expanding bare nitinol stents throughout the vein graft achieving complete revascularization, good medium term patency, and dramatically improved wound healing.
Endovascular recanalization using multiple bare stents could be an alternative treatment for infra-inguinal autologous vein graft occlusion.
对于腹股沟下自体静脉旁路移植血管闭塞的患者，通常采用传统的开放手术修复或针对天然血管闭塞的血管腔内治疗（EVT）。
一名73岁女性，左小腿有不愈合溃疡和坏疽，被诊断为腹股沟下自体大隐静脉移植血管闭塞。在这种情况下，由于之前聚四氟乙烯（PTFE）血管假体反复感染且既往手术导致无可利用的自体静脉，诸如补片血管成形术、间置移植或置换移植等手术修复似乎没有希望。此外，由于近端股浅动脉（SFA）已被切除，没有机会穿过天然血管。因此，对闭塞的自体静脉移植血管进行了EVT，在整个静脉移植血管内植入多个自膨式裸镍钛合金支架，实现了完全再血管化、良好的中期通畅率，并显著改善了伤口愈合。
使用多个裸支架进行血管腔内再通可能是腹股沟下自体静脉移植血管闭塞的一种替代治疗方法。
