Guzman-Stein G, Schubert W, Najarian D W, Press B H, Cunningham B L
Division of Plastic and Reconstructive Surgery, University of Minnesota Medical School, Minneapolis 55455.
Plast Reconstr Surg. 1989 Mar;83(3):533-6. doi: 10.1097/00006534-198903000-00025.
Chronic upper extremity arterial insufficiency is rare. Consequently, major reports specifically limited to the topic are scarce, and the clinical experience is small. In addition, symptomatology, diagnostic criteria, and guidelines for surgical management remain ill-defined. In the lower extremities, however, in situ vein bypass has been attempted for nearly three decades. This technique offers many advantages over traditional revascularization methods. Although the procedure has become popular for the lower extremity, no report of its use in the upper extremity is found in the literature. We report what may be the first case in which in situ bypass was used in the upper extremity for a threatened limb secondary to diabetic occlusive vascular disease complicated by a previous shunt used for hemodialysis. Revascularization of the upper extremity using the in situ vein bypass technique may offer a new alternative to traditional methods of revascularization.
慢性上肢动脉供血不足较为罕见。因此，专门针对该主题的主要报告很少，临床经验也有限。此外，症状学、诊断标准以及手术管理指南仍不明确。然而，在下肢，原位静脉搭桥术已尝试了近三十年。与传统的血管重建方法相比，该技术具有许多优势。尽管该手术在下肢已很常见，但文献中未发现其在上肢应用的报道。我们报告了可能是首例将原位搭桥术用于上肢的病例，该患者因糖尿病闭塞性血管疾病继发肢体威胁，且之前因血液透析进行过分流手术。使用原位静脉搭桥技术进行上肢血管重建可能为传统血管重建方法提供一种新的选择。
