Di Primio M, Angelopoulos G, Lazareth I, Priollet P, Zins M, Emmerich J, Yannoutsos A
Interventional radiology department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
Interventional radiology department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
J Med Vasc. 2020 Feb;45(1):23-27. doi: 10.1016/j.jdmv.2019.09.005. Epub 2019 Oct 12.
In the absence of feasible revascularization, nearly one third of patients with critical limb ischemia experienced major amputation at 6 months. In patients with an independent living status, this decision is difficult to support without exhausting all chances to attain limb salvage and preserve functional autonomy. The present report describes a new procedure of revascularization by performing a full endovascular extra-anatomic femoropopliteal bypass for the treatment of limb-threatening ischemia. The patient presented with extensive tissue loss and a short-term risk of major amputation. She had experienced previous failure of conventional surgical and endovascular revascularization procedures and ligation of proximal femoral artery precluded any further revascularization attempt. Limb salvage was achieved with this endovascular revascularization procedure with complete wound closure. The patient still presents an independent living status and preserved functional autonomy without wound recurrence after a follow-up of more than 5 years.
在缺乏可行的血运重建的情况下，近三分之一的严重肢体缺血患者在6个月时接受了大截肢手术。对于独立生活的患者，如果不竭尽全力争取保肢并保留功能自主性，很难支持这样的决定。本报告描述了一种新的血运重建手术，即通过进行完全血管腔内解剖外股腘动脉旁路移植术来治疗威胁肢体的缺血。该患者出现广泛的组织缺失和短期内进行大截肢的风险。她之前经历过传统外科和血管腔内血运重建手术失败，并且股动脉近端结扎使得无法进行进一步的血运重建尝试。通过这种血管腔内血运重建手术实现了保肢，伤口完全愈合。经过5年多的随访，患者仍保持独立生活状态，功能自主性得以保留，且伤口未复发。
