Gaudin Antoine, Jayet Jérémie, Decaix Victor, Davaine Jean Michel, Couture Thibault, Gaudric Julien, Chiche Laurent, Koskas Fabien
Department of Vascular Surgery, La Pitié Salpétrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.
Department of Vascular Surgery, La Pitié Salpétrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.
Ann Vasc Surg. 2020 Jul;66:631-635. doi: 10.1016/j.avsg.2020.01.091. Epub 2020 Feb 8.
In the endovascular era, angioplasty has grown a large place in the treatment of peripheral artery disease. Few studies have been focused in short atherosclerotic lesions of the popliteal artery itself, which remain for many surgeons a critical zone for the technical approach decision. We herein describe simple techniques of popliteal endarterectomy for the treatment of short popliteal occlusive disease.
Between January 2011 and June 2019, patients with isolated popliteal artery atherosclerotic lesions were included in this retrospective study. Indication for intervention was either disabling lower limb claudication or critical limb ischemia. We performed either endarterectomy by eversion of the popliteal artery or a simple endarterectomy with a patch angioplasty. We then studied the procedural data, the thirty-day outcomes, and the mid-term follow-up.
A total of 17 patients were included in the study, and 18 limbs were revascularized with the endarterectomy technique. Total duration of the procedure was 100 ± 46 min. Overall technical success was 100%. Median hospital stay was 4 days. Complete clinical success, that is, freedom from claudication or rest pain, was achieved in all cases. No early additional procedure was needed. After a mean follow-up of 34 ± 32 months with no patient lost to follow-up, all patients were alive, and a 100% primary patency and limb salvage was observed.
At 3 years' follow-up, endarterectomy of the popliteal artery appears to be a valid option for isolated and short atherosclerotic lesions.
在血管内治疗时代，血管成形术在周围动脉疾病的治疗中占据了重要地位。很少有研究聚焦于腘动脉本身的短段动脉粥样硬化病变，而这对许多外科医生来说仍是技术方法选择的关键区域。我们在此描述用于治疗短段腘动脉闭塞性疾病的腘动脉内膜切除术的简单技术。
在2011年1月至2019年6月期间，将孤立性腘动脉粥样硬化病变患者纳入这项回顾性研究。干预指征为致残性下肢间歇性跛行或严重肢体缺血。我们采用腘动脉外翻内膜切除术或单纯内膜切除术加补片血管成形术。然后我们研究了手术数据、30天的结果以及中期随访情况。
共有17例患者纳入研究，18条肢体通过内膜切除术实现了血运重建。手术总时长为100±46分钟。总体技术成功率为100%。中位住院时间为4天。所有病例均实现了完全临床成功，即无间歇性跛行或静息痛。无需早期进行额外手术。平均随访34±32个月，无患者失访，所有患者均存活，观察到原发性通畅率和肢体挽救率均为100%。
在3年的随访中，腘动脉内膜切除术对于孤立性短段动脉粥样硬化病变似乎是一种有效的选择。
