Capdevila J M, Marco-Luque M A, Cairols M A, Rancaño J, Simeon J M
Servicio de Cirugia Vascular, Hospital de Bellvitge, Barcelona, Spain.
Ann Vasc Surg. 1986 May;1(1):24-9. doi: 10.1016/S0890-5096(06)60698-5.
From 1976 to 1981 a total of 304 aortoiliac thromboendarterectomies (TEA) were carried out. Of these, 47 (16%) were performed in young patients: 25 cases were done through a transperitoneal and 22 through a retroperitoneal approach. All retroperitoneal operations were unilateral. All patients were smokers. Twenty-seven patients had incapacitant claudication, 14 had rest pain and 6 had necrotic lesions. Patency rates at four years were 78% for transperitoneal TEA and 79% for retroperitoneal unilateral TEA. These patency rates compared favorably with those obtained using similar techniques in patients over 50 years of age. In this older group, similar 4 year patency rates were 85% and 82%, respectively. The morbidity and mortality of these approaches was analyzed in patients above and below the age of 50. Our results support the use of TEA in young patients with symptomatic advanced atherosclerosis and question the wisdom of limiting the use of TEA to localized segmental lesions of the aortoiliac segment.
1976年至1981年期间，共进行了304例主-髂动脉血栓内膜切除术（TEA）。其中，47例（16%）在年轻患者中实施：25例经腹进行，22例经腹膜后途径进行。所有腹膜后手术均为单侧。所有患者均为吸烟者。27例患者有致残性跛行，14例有静息痛，6例有坏死性病变。经腹TEA四年通畅率为78%，腹膜后单侧TEA为79%。这些通畅率与50岁以上患者采用类似技术所获得的通畅率相比具有优势。在这个年龄较大的组中，类似的四年通畅率分别为85%和82%。对50岁上下患者这些手术方法的发病率和死亡率进行了分析。我们的结果支持在有症状的晚期动脉粥样硬化年轻患者中使用TEA，并质疑将TEA的使用局限于主-髂动脉节段局限性病变的合理性。
