股腘动脉搭桥治疗间歇性跛行失败的后果。
Consequences of failure of femoro-popliteal grafts for claudication.
作者信息
Blankensteijn J D, van Vroonhoven T J
机构信息
Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands.
出版信息
Eur J Vasc Surg. 1988 Jun;2(3):183-9. doi: 10.1016/s0950-821x(88)80073-2.
In order to evaluate the repercussions of failure of femoro-popliteal reconstruction undertaken for claudication the records of 219 patients with 251 femoro-popliteal conduits were reviewed. Autogenous Saphenous Vein graft (SV) was used in 109 limbs, Polytetrafluoroethylene graft (PTFE) in 101 and human umbilical vein graft (HUV) in 41. Primary patency rates after 3 years of follow-up of 72% for all grafts, 81% for SV-grafts, 84% for HUV-grafts and 59% for PTFE-grafts were calculated: the difference between SV-grafts and PTFE-grafts is statistically significant (P = 0.0047). Accordingly the authors advise against the use of PTFE-grafts in femoro-popliteal reconstruction. Including reinterventions secondary patency rates after 3 years of follow-up of 88% for all grafts, 86% for SV-grafts, 94% for HUV-grafts and 79% for PTFE-grafts were found: these differences were statistically not significant. Further analysis of the occluded grafts showed that in case of graft failure one or two re-operations are justified. The 12-months patency rate of reinterventions was 58%. Considering the life-expectancy and the natural history for the next five years of a patient with claudication the authors have become conservative towards femoro-popliteal reconstruction for claudication.
为了评估因间歇性跛行而进行的股腘动脉重建失败的影响，回顾了219例患者251条股腘动脉血管的记录。109条肢体使用了自体大隐静脉移植物（SV），101条使用了聚四氟乙烯移植物（PTFE），41条使用了人脐静脉移植物（HUV）。计算出所有移植物随访3年后的原发性通畅率为72%，SV移植物为81%，HUV移植物为84%，PTFE移植物为59%：SV移植物和PTFE移植物之间的差异具有统计学意义（P = 0.0047）。因此，作者建议在股腘动脉重建中不要使用PTFE移植物。包括再次干预后，随访3年后所有移植物的继发性通畅率为88%，SV移植物为86%，HUV移植物为94%，PTFE移植物为79%：这些差异在统计学上不显著。对闭塞移植物的进一步分析表明，在移植物失败的情况下，进行一到两次再次手术是合理的。再次干预的12个月通畅率为58%。考虑到间歇性跛行患者的预期寿命和未来五年的自然病程，作者对因间歇性跛行而进行的股腘动脉重建变得保守。
Zotero 插件