Akiyoshi Kei, Arakawa Mamoru, Matsumoto Harunobu, Adachi Koichi, Nakata Hiroko
Department of Cardiovascular Surgery, Yokosuka Uwamachi Hospital, Yokosuka, Kanagawa, Japan.
Department of Vascular Surgery, Saitama Medical University Hospital, Saitama, Saitama, Japan.
Ann Vasc Dis. 2022 Dec 25;15(4):333-336. doi: 10.3400/avd.cr.22-00059.
A 78-year-old man presented with severe stage 3 (Fontaine IV, Rutherford 5, W1 I3 FI0) right limb ischemia. Although his artery was completely occluded from below the right external iliac to the popliteal artery, collateral circulation from the right lateral femoral circumflex artery was well developed and supplied the lower extremity arteries. We selected an uncommon crossover bypass strategy with the left common femoral artery to the right lateral femoral circumflex artery to improve lower extremity perfusion via indirect revascularization. Bypass using the lateral femoral circumflex artery as an outflow is an option for patients with major lower extremity artery occlusions.
一名78岁男性患者出现严重的3期(Fontaine IV级、Rutherford 5级、W1 I3 FI0)右下肢缺血。尽管其动脉从右髂外动脉以下至腘动脉完全闭塞,但右股外侧旋动脉的侧支循环发育良好,并为下肢动脉供血。我们选择了一种不常见的交叉旁路策略,即从左股总动脉至右股外侧旋动脉,通过间接血运重建来改善下肢灌注。对于主要下肢动脉闭塞的患者,使用股外侧旋动脉作为流出道进行旁路手术是一种选择。