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主髂动脉闭塞性疾病患者的股-股动脉旁路移植术:病例报告

Femorofemoral artery bypass grafting in aortoiliac occlusive disease patients: A case report.

作者信息

Adriani Tom Christy, Lie Hendry, Faruk Muhammad

机构信息

Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Department of Surgery, Wahidin Sudirohusodo Hospital, Makassar, Indonesia.

Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

出版信息

Int J Surg Case Rep. 2022 Oct;99:107689. doi: 10.1016/j.ijscr.2022.107689. Epub 2022 Sep 19.

Abstract

INTRODUCTION

In May 2007, the Trans-Atlantic Inter-Society Consensus document on peripheral arterial disease management (TASC II) was released. These guidelines were developed to assist in the rational choice of open or endovascular approaches to aortoiliac disease.

CASE PRESENTATION

A 46-year-old woman was referred to the accident and emergency department, presenting with the chief complaint of pain in the left leg during activity. The pain had reduced after 10 min of resting before the time of admittance. Furthermore, there was weakness and sensory loss in the left leg; however, ulcers or gangrene were not found in the distal area. In addition, the left femoral pulse was not palpable, with ankle-brachial indices (ABIs) of 1.11 and 0 for the right and left, respectively. A computed tomography (CT) angiography of the aorta and lower limbs was requested. The findings were consistent with total occlusions from the distal portion of the aorta to the left common iliac artery, with atherosclerosis of the abdominal aorta (aortoiliac lesions type D TASC II classification). Subsequently, bypass grafting was performed immediately after revascularization with the femorofemoral artery. There were no post-operative sequelae, and the patient was admitted to the hospital for wound care.

CONCLUSION

Patients with aortoiliac occlusive disease are at risk of limb loss when revascularization is not performed and have an increased risk of cardiovascular events. The use of femorofemoral artery bypass grafting as a surgical technique had a high success rate, resulting in good perfusion to the lower extremities during a single operation.

摘要

引言

2007年5月,发布了关于外周动脉疾病管理的跨大西洋跨学会共识文件(TASC II)。制定这些指南是为了帮助合理选择主动脉髂动脉疾病的开放手术或血管内治疗方法。

病例介绍

一名46岁女性被转诊至急诊科,主要症状为活动时左腿疼痛。入院前休息10分钟后疼痛减轻。此外,左腿有无力和感觉丧失;然而,远端未发现溃疡或坏疽。此外,左侧股动脉搏动触诊不清,右侧和左侧的踝肱指数(ABI)分别为1.11和0。要求对主动脉和下肢进行计算机断层扫描(CT)血管造影。结果与从主动脉远端至左髂总动脉的完全闭塞一致,腹主动脉存在动脉粥样硬化(TASC II分类的主动脉髂动脉病变D型)。随后,在股股动脉血管重建后立即进行旁路移植术。术后无后遗症,患者入院接受伤口护理。

结论

主动脉髂动脉闭塞性疾病患者在未进行血管重建时存在肢体丧失风险,心血管事件风险增加。使用股股动脉旁路移植术作为一种手术技术成功率高,在单次手术中可实现下肢良好灌注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/645a/9568772/f0f732aa8c52/gr1.jpg

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