Yasa Ketut Putu, Ryalino Christopher
Department of Surgery, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia.
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia.
Am J Case Rep. 2020 Aug 17;21:e925009. doi: 10.12659/AJCR.925009.
BACKGROUND An extra-anatomic bypass is the choice of revascularization method for limb salvage in patients with infra-renal aortailiac occlusion accompanied by severe comorbidities. CASE REPORT We report a case of aortailiac-occlusive disease in a 59-year-old man with severe cormobidities. He had complained about intermittent claudication in both lower limbs for the past 10 years. The condition had worsened over the last 5 months, making it difficult for him to walk. Three attempts had been made at percutaneous aortailiac stenting, all of which were unsuccessful. The patient had a history of coronary artery disease and complete revascularization by percutaneous coronary stenting 10 years ago. Extra-anatomic axillounifemoral bypass was performed under general anesthesia. The results were good, with improvement in the patient's distal perfusion immediately and at 1-month follow-up. CONCLUSIONS After failed aortoiliac stenting, when direct revascularization aortofemoral bypass and endovascular intervention could not be carried out, extra-anatomic axillofemoral bypass was effective for revascularization in a patient with aortoiliac-occlusive disease and severe comorbidities.
对于合并严重共病的肾下腹主动脉髂动脉闭塞患者，解剖外旁路是肢体挽救血管重建方法的选择。
我们报告一例59岁患有严重共病的男性的主动脉髂动脉闭塞性疾病。在过去10年里，他一直抱怨双下肢间歇性跛行。在过去5个月里病情恶化，导致他行走困难。曾尝试3次经皮主动脉髂动脉支架置入术，但均未成功。该患者有冠状动脉疾病史，10年前通过经皮冠状动脉支架置入术实现了完全血管重建。在全身麻醉下进行了解剖外腋股动脉旁路移植术。结果良好，患者的远端灌注在术后即刻及1个月随访时均有改善。
在主动脉髂动脉支架置入失败后，当无法进行直接血管重建的主动脉股动脉旁路移植术和血管内介入治疗时，解剖外腋股动脉旁路移植术对于主动脉髂动脉闭塞性疾病合并严重共病的患者的血管重建是有效的。
