Friedman S G, Batista R J, Moccio C G
North Shore University Hospital, Division of Vascular Surgery, Manhasset, NY 11030.
Surgery. 1988 Mar;103(3):311-4.
In the patient with limb-threatening ischemia and aortoiliac occlusive disease surgical reconstruction with a prosthetic bypass, because of its safety and durability, has emerged as the treatment of choice. In obese patients, however, such therapy might be eschewed because of the frequent coexistence of multiple risk factors and the large size of these patients. In ten obese patients who had limb-threatening ischemia or rapidly worsening disabling claudication and aortoiliac occlusive disease, direct aortoiliac reconstruction was performed. There were no perioperative deaths, and only one major complication occurred in this group. The cumulative 5-year graft limb-patency and limb-salvage rates were each 90%. Despite the higher risk and unusual technical challenges that obese patients may present, direct reconstruction is the preferred treatment for aortoiliac occlusive disease and limb-threatening ischemia.
对于患有肢体威胁性缺血和主髂动脉闭塞性疾病的患者，采用人工血管旁路进行手术重建因其安全性和耐久性已成为首选治疗方法。然而，在肥胖患者中，由于多种危险因素常常并存且患者体型较大，这种治疗方法可能会被避免。在10例患有肢体威胁性缺血或迅速恶化的致残性间歇性跛行以及主髂动脉闭塞性疾病的肥胖患者中，进行了直接主髂动脉重建术。该组无围手术期死亡病例，仅发生1例严重并发症。5年移植物肢体通畅率和肢体挽救率累计均为90%。尽管肥胖患者可能存在更高的风险和特殊的技术挑战，但直接重建仍是主髂动脉闭塞性疾病和肢体威胁性缺血的首选治疗方法。
