Downs A R
Can J Surg. 1986 Sep;29(5):342-4.
The commonest late complication of aortofemoral prosthetic grafting is graft-limb occlusion, the usual cause of which is outflow obstruction due to anastomotic neointimal hyperplasia or progressive atherosclerosis in the deep femoral artery. Occasionally graft-limb occlusion is due to thrombosis of an anastomotic false aneurysm or is associated with graft infection. Inflow occlusion at the aortic anastomosis is uncommon unless the aortic anastomosis is at the lower end of the aorta distal to the inferior mesenteric artery. When graft-limb occlusion occurs, severe ischemia usually necessitates urgent revascularization to save the leg. Graft thrombectomy and profundaplasty may be successful; however, a cross-femoral graft to the distal patent deep femoral artery is probably the simplest procedure and is usually effective. Occasionally a distal femoropopliteal reconstruction is necessary to establish a satisfactory outflow. Unsuccessful reconstruction of a graft-limb occlusion usually necessitates a high, above-knee amputation.
主动脉股动脉人工血管移植最常见的晚期并发症是移植肢体闭塞，其常见原因是吻合口内膜增生或股深动脉进行性动脉粥样硬化导致的流出道梗阻。偶尔，移植肢体闭塞是由于吻合口假性动脉瘤血栓形成或与移植感染有关。除非主动脉吻合口位于肠系膜下动脉远端的主动脉下端，否则主动脉吻合口处的流入道闭塞并不常见。当移植肢体闭塞发生时，严重缺血通常需要紧急血管重建以挽救肢体。移植血管血栓切除术和股深动脉成形术可能成功；然而，将交叉股动脉移植至远端通畅的股深动脉可能是最简单的手术，且通常有效。偶尔需要进行远端股腘动脉重建以建立满意的流出道。移植肢体闭塞重建失败通常需要进行高位膝上截肢。
