Anton G E, Hertzer N R, Beven E G, O'Hara P J, Krajewski L P
J Vasc Surg. 1986 Jan;3(1):125-34.
Graft replacement was performed for 123 (77%) of 160 popliteal aneurysms evaluated at The Cleveland Clinic from 1952 to 1984, employing autogenous saphenous vein in 58 (36%), polytetrafluoroethylene in 19 (12%), and of historic interest, Dacron (12%) or arterial homograft (16%) in 46. The 10-year cumulative patency (CP) rate was 56% and the limb salvage (LS) rate was 83% following graft replacement, but late results were superior in patients who received vein bypass (CP, 94%; LS, 98%), in those who underwent revascularization before ischemic complications had occurred (CP, 92%; LS, 96%), and in those who recovered both pedal pulses (CP, 64%; LS, 96%). Long-term asymptomatic limbs were restored in 96%, 92%, and 89% of these subsets, respectively, compared with 65% of those receiving other graft materials (p = 0.00003), 59% of those with preoperative ischemic symptoms (p = 0.00001) and 68% of those regaining only an isolated popliteal pulse (p = 0.0326). These data indicate that popliteal aneurysms should be corrected by vein bypass to a patent tibioperoneal segment before spontaneous thrombosis or embolization eliminates the critical outflow bed.
1952年至1984年在克利夫兰诊所评估的160例腘动脉瘤中，123例（77%）进行了移植物置换，其中58例（36%）采用自体隐静脉，19例（12%）采用聚四氟乙烯，另外46例采用了具有历史意义的涤纶（12%）或同种异体动脉移植物（16%）。移植物置换后10年的累积通畅率（CP）为56%，肢体挽救率（LS）为83%，但接受静脉旁路移植的患者（CP，94%；LS，98%）、在缺血并发症发生前行血管重建的患者（CP，92%；LS，96%）以及恢复双侧足背动脉搏动的患者（CP，64%；LS，96%）的远期效果更好。这些亚组中分别有96%、92%和89%的患者长期肢体无症状，相比之下，接受其他移植物材料的患者为65%（p = 0.00003），术前有缺血症状的患者为59%（p = 0.00001），仅恢复孤立腘动脉搏动的患者为68%（p = 0.0326）。这些数据表明，在自发血栓形成或栓塞消除关键流出道之前，应通过静脉旁路移植至通畅的胫腓段来纠正腘动脉瘤。
