Kikuchi Shinsuke, Azuma Nobuyoshi
Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Japan.
Kyobu Geka. 2019 Sep;72(10):757-761.
Femoral artery and veins and axillary artery are one of the major vessels in the human body which are easily accessible to circulation. Therefore, these vessels are usually used for cardiac and aortic surgeries to establish extracorporeal circulation through surgical as well as percutaneous technique. Additionally, with increasing a minimally invasive fashion for treatment of cardiac and aortic diseases, these accessible arteries are frequently manipulated, for example transcatheter aortic valve implantation, debranching thoracic endovascular aortic repair and endovascular aneurysm repair. Thus, exposure of the vessels is a basic procedure in this field;cardiac and vascular surgeons need understanding anatomical knowledge of the arteries and the surrounding structures, such as muscles and nerves. Especially, it becomes frequent for surgeons to see a bleeding complication with the increasing endovascular therapy and a calcified and atherosclerotic artery due to peripheral artery disease;these situations increase difficulty of femoral artery exposure. Deep understanding of anatomical knowledge helps to obtain good surgical exposure. We hope that it describes some useful improvements to surgical technique and anatomical understanding of cardiac and vascular surgeons.
股动脉、股静脉和腋动脉是人体中易于进行循环操作的主要血管之一。因此，这些血管通常用于心脏和主动脉手术，通过手术及经皮技术建立体外循环。此外，随着心脏和主动脉疾病治疗的微创方式不断增加，这些易于触及的动脉经常被操作，例如经导管主动脉瓣植入术、去分支胸主动脉腔内修复术和血管内动脉瘤修复术。因此，血管暴露是该领域的基本操作；心脏和血管外科医生需要了解动脉及其周围结构（如肌肉和神经）的解剖知识。特别是，随着血管内治疗的增加以及由于外周动脉疾病导致动脉钙化和动脉粥样硬化，外科医生经常会遇到出血并发症；这些情况增加了股动脉暴露的难度。对解剖知识的深入理解有助于获得良好的手术暴露。我们希望它能描述一些对心脏和血管外科医生手术技术和解剖学理解的有益改进。
